End effectors and methods for driving tools guided by surgical robotic systems

ABSTRACT

End effectors for driving tools at surgical sites along trajectories maintained by surgical robots. A tool has interface and working ends. An end effector has a mount to attach to the surgical robot, and an actuator configured to generate torque. A drive assembly with a geartrain translates rotation from the actuator into rotation of a drive conduit supported about an axis. A rotational lock operatively attached to the drive conduit releasably secures the tool for concurrent rotation about the axis, and an axial lock releasably secures the tool for concurrent translation with the drive conduit along the trajectory maintained by the surgical robot. The axial lock is operable between a release configuration where relative movement between the drive assembly and the tool is permitted along the axis, and a lock configuration where relative movement between the drive assembly and the tool is restricted along the axis.

CROSS-REFERENCE TO RELATED APPLICATIONS

The subject patent application claims priority to and all the benefitsof U.S. Provisional Patent Application No. 62/622,306 filed on Jan. 26,2018, and U.S. Provisional Patent Application No. 62/744,878 filed onOct. 12, 2018, the disclosures of which are each hereby incorporated byreference in their entirety.

BACKGROUND

Surgical robotic systems are frequently used to assist medicalprofessionals in carrying out various types of surgical procedures. Tothis end, a surgeon may use a surgical robot to guide, position, move,actuate, or otherwise manipulate various tools, components, prostheses,and the like during a surgery.

It will be appreciated that surgical robots can be used to assistsurgeons in performing a number of different types of surgicalprocedures. By way of illustration, surgical robots are commonly used inprocedures involving the correction, stabilization, resection, orreplacement of one or more parts of a patient's body, such as to helpimprove patient mobility, reduce pain, mitigate the risk of subsequentinjury or damage, and the like.

By way of illustrative example, in many types of spinal procedures(e.g., a posterior lumbar interbody fusion “PLIF”), robotic systemsadvantageously help facilitate proper installation of pedicle screws atdiscrete locations in vertebrae of the patient's spine. The pediclescrews serve as anchors and typically cooperate with additional fixationhardware (e.g., stabilization rods) to restrict movement betweenanchored vertebrae which, in turn, helps ensure that bone graftsdisposed between adjacent vertebrae can successfully fuse together.

When a patient requires surgery that involves placing pedicle screws,pre-operative imaging and/or intra-operative imaging are often utilizedby the surgeon to help visualize the patient's anatomy (e.g., vertebraeof the patient's spine). The surgeon typically plans where to place thepedicle screws based on the pre-operative imaging, such as with imagescaptured of the patient's anatomy, 3D models created from the images,and the like. Planning includes determining a desired position andorientation (i.e., pose) of each pedicle screw with respect to theparticular vertebra in which it is to be placed, such as by identifyingthe desired pose in the pre-operative images and/or 3D models. Once set,the plan is transferred to the robotic system for execution.

Typically, the robotic system comprises a surgical robot with a roboticarm that positions a tool guide above the patient and along a desiredtrajectory that is aligned with the desired orientation of the pediclescrew to be placed. The robotic system also comprises a navigationsystem to determine a location of the tool guide with respect to thepatient's anatomy so that the robotic arm can position the tool guidealong the desired trajectory according to the surgeon's plan. In somecases, the navigation system includes tracking devices attached to thesurgical robot and to the patient's body so that the robotic system canmonitor and respond to movement during the surgical procedure bydynamically moving the tool guide to as needed to maintain the desiredtrajectory.

In minimally-invasive surgical techniques, once the tool guide has beenaligned with the desired trajectory, the surgeon generally positions acannula through the tool guide, which extends into an incision made inthe patient's body adjacent to the vertebra at the surgical site. Thesurgeon then attaches a drill bit to a hand-held drill, inserts thedrill bit into the cannula, and actuates the drill to form a pilot holefor the pedicle screw. The surgeon then removes the drill bit andsubsequently drives the pedicle screw into position in the pilot holewith a hand-held driver to install the pedicle screw into the vertebra.

In the types of spinal surgical techniques described above, the roboticarm is somewhat underutilized and plays little to no role in actuallydrilling the pilot hole or installing the pedicle screw. Moreover,despite the advantages afforded by the surgical system's ability tomaintain the trajectory, conventional minimally-invasive techniquesoften necessitate that the robotic arm be repositioned several timeswhen installing a single pedicle screw. The frequency and extent of thisrepositioning depends, among other things, on the specific type ofsurgical technique being utilized, the preferences of the surgeon, aswell as the configuration of the pedicle screw, the guide tool, thedrill, and the surgical robot itself.

Furthermore, because multiple pedicle screws are usually installedduring a single surgery (e.g., a total of four pedicle screws are oftenemployed in a bilateral interbody fusion of two adjacent vertebrae), itmay be difficult to efficiently articulate the robotic arm betweendifferent trajectories without inconveniencing the surgeon's approach.Moreover, in some circumstances, the surgical robot itself may have tobe repositioned relative to the patient's body when the requisitearticulation of the robotic arm is impractical to achieve betweendifferent trajectories, and/or so as to afford the surgeon with aconsistent approach along each trajectory.

Accordingly, there remains a need in the art for addressing one or moreof these deficiencies.

SUMMARY

The present disclosure provides an end effector for driving a tool at asurgical site along a trajectory maintained by a surgical robot. The endeffector comprises a mount adapted to attach to the surgical robot, arotary instrument coupled to the mount and comprising an actuator whichis configured to generate rotational torque about a first axis. The endeffector also comprises a drive assembly with a geartrain to translaterotation from the rotary instrument into rotation about a second axisdifferent from the first axis, and a connector configured to releasablysecure the tool for rotation about the second axis. The end effectoralso comprises a trigger assembly with a grip to support a user's hand,and an input trigger in communication with the rotary instrument. Theinput trigger is arranged for engagement by the user to drive the rotaryinstrument and rotate the tool about the second axis. The end effectoralso comprises a manual interface to communicate with the driveassembly. The manual interface is arranged to receive and translateapplied force from the user into rotational torque to rotate the toolabout the second axis.

The present disclosure also provides an end effector for driving a toolat a surgical site along different trajectories selectively maintainedby a surgical robot. The end effector comprises a mount adapted toattach to the surgical robot, and a rotary instrument coupled to themount and comprising an actuator configured to generate rotationaltorque about a first axis. The end effector also comprises a driveassembly with a geartrain to translate rotation from the rotaryinstrument into rotation about a second axis different from the firstaxis, and a connector configured to releasably secure the tool forrotation about the second axis. A coupling is operatively attached tothe rotary instrument and is configured to releasably secure the driveassembly to the rotary instrument in a plurality of orientations toselectively position the second axis relative to the rotary instrumentalong different trajectories maintained by the surgical robot.

The present disclosure also provides an end effector for driving a toolat a surgical site along a trajectory maintained by a surgical robot,the tool having an interface end and a working end. The end effectorcomprises a mount adapted to attach to the surgical robot, and anactuator coupled to the mount and configured to generate rotationaltorque about a first axis. The end effector also comprises a driveassembly comprises a geartrain to translate rotation from the actuatorabout the first axis into rotation about a second axis, a drive conduitsupported for rotation about the second axis, a first rotational lockoperatively attached to the drive conduit to releasably secure the toolfor concurrent rotation about the second axis, and an axial lock toreleasably secure the tool for concurrent translation with the driveconduit along the trajectory maintained by the surgical robot. The axiallock is operable between a release configuration where relative movementbetween the drive assembly and the tool is permitted along the secondaxis, and a lock configuration where relative movement between the driveassembly and the tool is restricted along the second axis.

The present disclosure also provides an end effector for guiding toolsrelative to a surgical site along a trajectory maintained by a surgicalrobot, the tools including a first tool and a second tool different fromthe first tool. The end effector comprises a mount adapted to attach tothe surgical robot, and a rotary instrument coupled to the mount andcomprising an actuator configured to generate rotational torque about afirst axis. The end effector also comprises a drive assembly with ageartrain to translate rotation from the rotary instrument about thefirst axis into rotation about a second axis, a first rotational lockdisposed in rotational communication with the geartrain to releasablysecure the first tool for concurrent rotation about the second axis at afirst drive ratio, a second rotational lock disposed in communicationwith the geartrain to releasably secure the second tool for concurrentrotation about the second axis at a second drive ratio different fromthe first drive ratio, and an axial lock to releasably secure one of thefirst tool and the second tool for concurrent translation with the driveassembly along the trajectory maintained by the surgical robot. Theaxial lock is operable between a release configuration where relativemovement between the drive assembly and the secured tool is permittedalong the second axis, and a lock configuration where relative movementbetween the drive assembly and the secured tool is restricted along thesecond axis.

The present disclosure also provides an end effector for driving toolsat a surgical site along a trajectory maintained by a surgical robot,the tools including a first tool and a second tool different from thefirst tool. The end effector comprises a mount adapted to attach to thesurgical robot, and a rotary instrument coupled to the mount andcomprising an actuator configured to generate rotational torque about afirst axis. The end effector also comprises a drive assembly with ageartrain to translate rotation from the rotary instrument into rotationabout a second axis different from the first axis, a connectorconfigured to releasably secure one of the first tool and the secondtool for rotation about the second axis, and a transmission interposedin rotational communication between the rotary instrument and theconnector. The transmission comprises a first gearset, a second gearset,and a shift collar arranged for movement between a first collar positionwhere the shift collar engages the first gearset to translate rotationbetween the rotary instrument and the connector at a first drive ratio,and a second collar position where the shift collar engages at thesecond gearset to translate rotation between the rotary instrument andthe connector at a second drive ratio different from the first driveratio.

The present disclosure also provides a method of forming a pilot hole ata surgical site along a trajectory maintained by a surgical robot. Themethod comprises attaching an end effector to the surgical robot, theend effector supporting an actuator, a drive assembly, a manualinterface, and a trigger assembly. The method also comprises attaching arotary cutting tool to the drive assembly along a second axis, aligningthe second axis with the trajectory to position the rotary cutting toolat the surgical site, and engaging the trigger assembly to generaterotational torque with the actuator about a first axis and to translatetorque from the actuator about the first axis through the drive assemblyto rotate the rotary cutting tool about the second axis. The method alsocomprises advancing the rotary cutting tool along the trajectory at thesurgical site to a first depth, interrupting rotation about the firstaxis, positioning the trigger assembly to present the manual interface,applying force to the manual interface to rotate the rotary cutting toolabout the second axis, and advancing the rotary cutting tool along thetrajectory at the surgical site to a second depth greater than the firstdepth.

The present disclosure also provides a method of installing an anchor ata surgical site along a trajectory maintained by a surgical robot. Themethod comprises attaching an end effector to the surgical robot, theend effector supporting an actuator, a drive assembly, a manualinterface, and a trigger assembly. The method also comprises attaching atool to the drive assembly along a second axis, attaching the anchor tothe tool, aligning the second axis with the trajectory to position theanchor adjacent to the surgical site, and engaging the trigger assemblyto generate rotational torque with the actuator about a first axis andto translate torque from the actuator about the first axis through thedrive assembly to rotate the tool and the anchor about the second axis.The method also comprises advancing the tool and the anchor along thetrajectory at the surgical site to a first depth, interrupting rotationabout the first axis, positioning the trigger assembly to present themanual interface, applying force to the manual interface to rotate thetool and the anchor about the second axis, and advancing the anchoralong the trajectory at the surgical site to a second depth greater thanthe first depth.

The present disclosure also provides a method of installing first andthe second anchors at a surgical site along respective first and secondtrajectories maintained by a surgical robot. The method comprisesattaching an end effector to the surgical robot, the end effectorsupporting an actuator, a drive assembly, a manual interface, and atrigger assembly. The method also comprises attaching a tool to thedrive assembly along a second axis, attaching the first anchor to thetool, aligning the second axis with the first trajectory to position thefirst anchor adjacent to the surgical site, and engaging the triggerassembly to generate rotational torque with the actuator about a firstaxis and to translate torque from the actuator about the first axisthrough the drive assembly to rotate the tool and the first anchor aboutthe second axis. The method also comprises advancing the tool and thefirst anchor along the first trajectory at the surgical site to a firstdepth, interrupting rotation about the first axis, positioning thetrigger assembly to present the manual interface, applying force to themanual interface to rotate the tool and the first anchor about thesecond axis, and advancing the tool and the first anchor along the firsttrajectory at the surgical site to a second depth greater than the firstdepth. The method further comprises releasing the first anchor from thetool, attaching the second anchor to the tool, aligning the second axiswith the second trajectory to position the second anchor adjacent to thesurgical site, engaging the trigger assembly to generate rotationaltorque with the actuator about the first axis, and translating torquefrom the actuator about the first axis through the drive assembly torotate the tool and the second anchor about the second axis. The methodfurther comprises advancing the tool and the second anchor along thesecond trajectory at the surgical site to a third depth, interruptingrotation about the first axis, positioning the trigger assembly topresent the manual interface, applying force to the manual interface torotate the tool and the second anchor about the second axis, andadvancing the tool and the second anchor along the second trajectory atthe surgical site to a fourth depth greater than the third depth.

Other features and advantages of the embodiments of the presentdisclosure will be readily appreciated, as the same becomes betterunderstood, after reading the subsequent description taken inconjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a surgical system comprising a surgicalrobot with a robotic arm supporting an end effector, according to afirst embodiment of the present disclosure, to which a tool is securedalong a trajectory adjacent to a surgical site on a patient's body.

FIG. 2A is a perspective view of the end effector, the tool, and aportion of the patient's body of FIG. 1, with the tool shown supportedalong a first trajectory.

FIG. 2B is another perspective view of the end effector, the tool, andthe portion of the patient's body of FIG. 2A, with the tool shownsupported along a second trajectory.

FIG. 2C is another perspective view of the end effector, the tool, andthe portion of the patient's body of FIGS. 2A-2B, with the tool shownsupported along a third trajectory.

FIG. 3 is a perspective view of the end effector of FIGS. 1-2C, the endeffector shown comprising a mount supporting a rotary instrument togenerate torque about a first axis and having a coupling, a driveassembly attached to the coupling of the rotary instrument andsupporting the tool for rotation about a second axis, a trigger assemblywith a grip and an input trigger arranged for engagement by a user todrive the rotary instrument, a manual interface to receive force torotate the tool about the second axis, and a handle assembly forengagement with the manual interface.

FIG. 4 is a partially-exploded perspective view of the end effector ofFIG. 3, shown with the drive assembly spaced from the rotary instrumentbelow the handle assembly and spaced from two tools configured forreleasable attachment to the drive assembly, with one of the tools shownas a rotary cutting tool with a drill bit, and with the other of thetools shown as an rotary driving tool supporting an anchor.

FIG. 5A is an illustrative view of a surgical site taken transverselythrough a patient's vertebra in connection with a minimally-invasivespinal fusion technique performed with the surgical system of FIGS. 1-4,depicting first and second trajectories arranged bilaterally relative tothe spinous process and extending through the respective pedicles intothe vertebral body on opposing sides of the foramen and spinal cord, andshown with an anchor installed along the first trajectory and with adrill bit guided along the second trajectory positioned adjacent to thevertebra.

FIG. 5B is another illustrative view of the surgical site of FIG. 5A,shown with the drill bit penetrating the vertebra along the secondtrajectory to form a pilot hole at a first depth extending through thepedicle and into the vertebral body.

FIG. 5C is another illustrative view of the surgical site of FIGS.5A-5B, shown with the drill bit advanced further along the trajectory toform the pilot hole at a second depth further into the vertebral body.

FIG. 5D is another illustrative view of the surgical site of FIGS.5A-5C, shown with the drill bit removed from the pilot hole and with ananchor supported by an rotary driving tool guided along the secondtrajectory positioned adjacent to the vertebra.

FIG. 5E is another illustrative view of the surgical site of FIGS.5A-5D, shown with the anchor being installed in the vertebra along thesecond trajectory to a third depth.

FIG. 5F is another illustrative view of the surgical site of FIGS.5A-5E, shown with the anchor installed in the vertebra along the secondtrajectory to a fourth depth.

FIG. 5G is another illustrative view of the surgical site of FIGS.5A-5F, shown with the anchors installed in the vertebra along respectivetrajectories.

FIG. 6 is a perspective view of the tool supporting the anchor of FIGS.1-5F.

FIG. 7 is a top-side plan view of the tool supporting the anchor ofFIGS. 1-6.

FIG. 8 is a section view taken along line 8-8 of FIG. 7.

FIG. 9 is an exploded perspective view of the tool shown spaced from theanchor of FIGS. 1-8.

FIG. 10A is a perspective view of the end effector of FIGS. 1-4, shownwith the trigger assembly arranged in a first trigger assembly positionwith the grip and the input trigger disposed above the manual interfaceadjacent to the drive assembly.

FIG. 10B is another perspective view of the end effector of FIG. 10A,shown with the trigger assembly arranged in a second trigger assemblyposition with the grip and the input trigger moved to present the manualinterface for engagement by the handle assembly.

FIG. 11A is a front-side plan view of the end effector of FIGS. 10A-10B,shown with the trigger assembly arranged in the first trigger assemblyposition, and with the coupling supporting the drive assembly in a firstorientation.

FIG. 11B is another front-side plan view of the end effector of FIG.11A, shown with the trigger assembly arranged in the second triggerassembly position, with the coupling supporting the drive assembly inthe first orientation, and with the handle assembly disposed adjacent tothe manual interface.

FIG. 11C is another front-side plan view of the end effector of FIGS.11A-11B, shown with the trigger assembly arranged in the second triggerassembly position, with the coupling supporting the drive assembly inthe first orientation, and with the handle assembly disposed inengagement with the manual interface.

FIG. 11D is another front-side plan view of the end effector of FIGS.11A-11C, shown with the trigger assembly arranged in the first triggerassembly position, and with the coupling supporting the drive assemblyin a second orientation.

FIG. 11E is another front-side plan view of the end effector of FIGS.11A-11D, shown with the trigger assembly arranged in the first triggerassembly position, and with the coupling supporting the drive assemblyin a third orientation.

FIG. 11F is another front-side plan view of the end effector of FIGS.11A-11E, shown with the trigger assembly arranged in a third triggerassembly position, and with the coupling supporting the drive assemblyin the third orientation.

FIG. 12 is a top-side plan view of the mount, the rotary instrument, thetrigger assembly, and the coupling of the end effector of FIGS. 1-4.

FIG. 13 is an offset section view taken along line 13-13 of FIG. 12.

FIG. 14 is an enlarged section view taken along indicia 14 of FIG. 13.

FIG. 15 is an enlarged section view taken along indicia 15 of FIG. 13.

FIG. 16 is a perspective view of the mount, the rotary instrument, thetrigger assembly, and the coupling of the end effector of FIG. 12.

FIG. 17 is a partially-exploded perspective view of the end effector ofFIG. 16, shown with the trigger assembly, the mount, and a retainer eachspaced from the rotary instrument.

FIG. 18 is another partially-exploded perspective view of the endeffector of FIG. 16, shown with portions of the retainer and the triggerassembly each spaced from the rotary instrument.

FIG. 19A is a perspective view of portions of the retainer and thetrigger assembly of the end effector of FIGS. 11A-18, shown with thetrigger assembly arranged in the first trigger assembly position, withthe input trigger arranged in a first input position, and shown withportions of the trigger assembly depicted in phantom.

FIG. 19B is another perspective view of the portions of the retainer andthe trigger assembly of the end effector of FIG. 19A, shown with thetrigger assembly arranged in the first trigger assembly position, withthe trigger arranged in a second input position, and shown with portionsof the trigger assembly depicted in phantom.

FIG. 19C is another perspective view of the portions of the retainer andthe trigger assembly of the end effector of FIGS. 19A-19B, shown withthe trigger assembly arranged in the third trigger assembly position,with the trigger arranged in the first input position, and shown withportions of the trigger assembly depicted in phantom.

FIG. 20A is a perspective view of the retainer of FIG. 17, shown havinga plunger disposed in a locked position to restrict movement of thetrigger assembly relative to the rotary instrument between the triggerassembly positions.

FIG. 20B is another perspective view of the retainer of FIG. 20A, shownwith the plunger disposed in an unlocked position to permit movement ofthe trigger assembly relative to the rotary instrument between thetrigger assembly positions.

FIG. 21 is a perspective view of the drive assembly of FIGS. 1-4, shownwith the manual interface and the connector arranged along the secondaxis.

FIG. 22 is a top-side plan view of the drive assembly of FIG. 21.

FIG. 23A is a section view taken along line 23-23 of FIG. 22, shown withthe drive assembly comprising a geartrain to translate torque from therotary instrument toward the connector to rotate the tool, and a clutchmechanism interposed between the manual interface and the geartrain,shown with the clutch mechanism operating in a first mode to effectrotation of the connector via torque from the rotary instrument withoutrotating the manual interface.

FIG. 23B is another section view depicting the of the geartrain, theclutch mechanism, and the connector of the drive assembly of FIG. 23A,shown with the clutch mechanism operating in a second mode to effectrotation of the connector from force applied to the manual interface.

FIG. 24 is an exploded perspective view of the drive assembly of FIGS.21-23B.

FIG. 25A is a perspective view of an end effector, according to a secondembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, a trigger assembly arranged in a first triggerassembly position, a drive assembly with a connector to support a toolfor rotation about a second axis, and a guard cover arranged in a firstguard position.

FIG. 25B is another perspective view of the end effector of FIG. 25A,shown with the trigger assembly arranged in a second trigger assemblyposition, and with the guard cover arranged in a second guard positionto promote access to a manual interface.

FIG. 26 is an exploded perspective view of the end effector of FIGS.25A-25B, shown with trigger assembly spaced between the drive assemblyand the rotary instrument.

FIG. 27A is a sectional perspective view of the trigger assembly ofFIGS. 25A-26, depicted as sectioned generally longitudinally, and shownhaving an input trigger arranged in a first input position.

FIG. 27B is another sectional perspective view of the trigger assemblyof FIG. 27A, shown with the input trigger arranged in a second inputposition.

FIG. 28 is a sectional perspective view of the drive assembly of FIGS.25A-26, depicted as sectioned generally longitudinally.

FIG. 29A is a perspective view of an end effector, according to a thirdembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, a drive assembly with a connector to support a toolfor rotation about a second axis, and a trigger assembly arranged in afirst trigger assembly position and shown having a first and secondframe bodies, with the second frame body disposed in a first gripposition to limit access to a manual interface.

FIG. 29B is another perspective view of the end effector of FIG. 29A,shown with the second frame body disposed in a second grip position topromote access to the manual interface.

FIG. 30 is an exploded perspective view of the end effector of FIGS.29A-29B, shown with the drive assembly spaced from the rotary instrumentand the trigger assembly, and shown with two tools configured forreleasable attachment to the drive assembly, with one of the tools shownas a rotary cutting tool with a drill bit, and with the other of thetools shown as an rotary driving tool supporting an anchor.

FIG. 31A is a sectional perspective view of the drive assembly and aportion of the rotary driving tool of FIG. 30, depicted as sectionedgenerally longitudinally, shown with a transmission having a shiftcollar arranged in a first collar position to engage a first gearset ofthe transmission.

FIG. 31B is a sectional perspective view of the drive assembly and aportion of the rotary cutting tool of FIG. 30, depicted as sectionedgenerally longitudinally, shown with a transmission having a shiftcollar arranged in a second collar position to engage a second gearsetof the transmission, with a portion of the rotary cutting tool disposedin engagement with a selector operatively attached to the shift collar.

FIG. 32 is a perspective view of an end effector, according to a fourthembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, a drive assembly with a connector to support a toolfor rotation about a second axis, a differential assembly, a pair ofpins, and a handle assembly supported in a dock.

FIG. 33 is an exploded perspective view of the end effector of FIG. 32,shown with the drive assembly spaced from the rotary instrument, thepins, and the handle assembly, and shown with two tools configured forreleasable attachment to the drive assembly, with one of the tools shownas a rotary cutting tool with a drill bit, and with the other of thetools shown as an rotary driving tool supporting an anchor.

FIG. 34A is a sectional perspective view of the drive assembly of FIG.33, depicted as sectioned generally longitudinally, shown with thedifferential assembly in communication with first and second rotationallocks of the drive assembly.

FIG. 34B is another sectional perspective view of the drive assembly ofFIG. 34A, shown with a portion of the rotary cutting tool depicted inFIG. 33 disposed in engagement with the first rotational lock of thedrive assembly for rotation about the second axis, and shown with one ofthe pins engaging a portion of the differential assembly.

FIG. 34C is another sectional perspective view of the drive assembly ofFIGS. 34A-34B, shown with a portion of the rotary driving tool depictedin FIG. 33 disposed in engagement with the second rotational lock of thedrive assembly for rotation about the second axis, and shown with theother of the pins engaging another portion of the differential assembly.

FIG. 35 is a perspective view of an end effector, according to a fifthembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, and a drive assembly with a drive conduit supportinga tool for rotation about a second axis, the tool depicted as a rotarycutting tool with a drill bit.

FIG. 36 is an exploded perspective view of the end effector of FIG. 35,shown with the drive assembly spaced from the rotary instrument and therotary cutting tool, and shown spaced from another tool depicted as anrotary driving tool for driving an anchor.

FIG. 37A is a sectional perspective view of the drive assembly of FIG.36, depicted as sectioned generally longitudinally, shown having atransmission with first and second gearset disposed in rotationalcommunication with the drive conduit.

FIG. 37B is another sectional perspective view of the drive assembly ofFIG. 37A, partially depicting portions of the rotary driving tool ofFIG. 36 secured in the drive conduit and engaging a selector operativelyattached to a shift collar of the transmission, and shown with the shiftcollar disposed in a first collar position to engage the first gearset.

FIG. 37C is another sectional perspective view of the drive assembly ofFIG. 37A, partially depicting portions of the rotary cutting tool ofFIGS. 35-36 secured in the drive conduit and engaging a selectoroperatively attached to a shift collar of the transmission, and shownwith the shift collar disposed in a second collar position to engage thesecond gearset.

FIG. 38A is a perspective view of the drive assembly of FIGS. 35-37C,shown with the selector of the transmission arranged as depicted in FIG.37B.

FIG. 38B is a perspective view of the drive assembly of FIGS. 35-37C,shown with the selector of the transmission arranged as depicted in FIG.37C.

FIG. 39A is a perspective view of an end effector, according to a sixthembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, a drive assembly with a drive conduit supporting atool for rotation about a second axis, and a trigger assembly arrangedin a first trigger assembly position and shown having a first and secondframe bodies, with the second frame body disposed in a first gripposition to limit access to a manual interface defined by the tool.

FIG. 39B is another perspective view of the end effector of FIG. 39A,shown with second frame body disposed in a second grip position topromote access to the manual interface defined by the tool.

FIG. 39C is another perspective view of the end effector of FIGS.39A-39B, shown with the trigger assembly arranged in a second triggerassembly position, and shown with the second frame body disposed in thesecond grip position.

FIG. 40 is an exploded perspective view of the end effector of FIGS.39A-39C, shown with the trigger assembly and the drive assembly spacedfrom the rotary instrument, and shown with two tools configured forreleasable attachment to the drive conduit of the drive assembly, withone of the tools shown as an rotary driving tool for supporting ananchor to be driven by the rotary instrument along the trajectorymaintained by the surgical robot, and with the other of the tools shownas a dissector tool to be guided along the trajectory maintained by thesurgical robot.

FIG. 41 is a partial sectional perspective view of the trigger assemblyof FIGS. 39A-40, depicted as sectioned generally longitudinally.

FIG. 42A is a side plan view of the end effector of FIGS. 39A-40, shownwith a light source operatively attached to a portion of the triggerassembly, with the trigger assembly arranged as depicted in FIG. 39A,and with the light source shown emitting light towards a surgical sitealong the second axis.

FIG. 42B is a side plan view of the end effector of FIGS. 39A-40, shownwith a tool comprising a light source supported in the drive conduit ofthe drive assembly, with the trigger assembly arranged as depicted inFIG. 39B, and with the light source shown emitting light towards asurgical site along the second axis.

FIG. 43A is a partially-exploded, sectional perspective view of thedrive assembly of FIGS. 39A-40, depicted as sectioned generallylongitudinally, and shown with an axial lock to releasably secure therotary driving tool of FIG. 40.

FIG. 43B is a sectional perspective view of the drive assembly of FIG.43A, shown with the dissector tool of FIG. 40 disposed in the driveconduit.

FIG. 43C is a sectional perspective view of the drive assembly of FIGS.43A-43B, shown with the rotary driving tool of FIG. 40 secured to thedrive conduit by the axial lock and by a rotational lock.

FIG. 43D is another sectional perspective view of the drive assembly,the rotary driving tool, and the rotational lock of FIG. 43C, depictedas sectioned along a plane (not shown) arranged about the second axisand disposed at acute angle relative to a longitudinal plane (not shown)arranged about the first axis.

FIG. 44A is another sectional perspective view of the drive assembly,the rotary driving tool, and the rotational lock of FIGS. 43C-43D,depicted as sectioned along a plane (not shown) arranged perpendicularto the second axis and through the axial lock shown arranged in a lockconfiguration.

FIG. 44B is another sectional perspective view of the drive assembly,the rotary driving tool, and the rotational lock of FIG. 44A, shown withthe axial lock arranged in a released configuration.

FIG. 45 is a perspective view of an end effector, according to a seventhembodiment of the present disclosure, which is likewise configured foruse with the surgical system of FIG. 1, the end effector showncomprising a mount supporting a rotary instrument to generate torqueabout a first axis, a drive assembly with a drive conduit supporting atool for rotation about a second axis, and a trigger assembly.

FIG. 46 is an exploded perspective view of the end effector of FIG. 45,shown with the drive assembly spaced from the rotary instrument and thetrigger assembly, and shown with two tools configured for releasableattachment to the drive conduit of the drive assembly, with one of thetools shown as a rotary cutting tool with a drill bit to be driven bythe rotary instrument along the trajectory maintained by the surgicalrobot, and with the other of the tools shown as a scalpel tool to beguided along the trajectory maintained by the surgical robot.

FIG. 47A is a sectional perspective view of the drive assembly of FIGS.45-46, depicted as sectioned generally longitudinally, and show with thedrive conduit comprising a collet mechanism having a collet tensionerarranged in a lock configuration.

FIG. 47B is another sectional perspective view of the drive assembly ofFIG. 47A, shown with the collet tensioner arranged in a releaseconfiguration.

FIG. 47C is another sectional perspective view of the drive assembly ofFIG. 47A, shown with the collet tensioner arranged in the lockconfiguration to secure a portion of the rotary cutting tool of FIG. 46for rotation about the second axis.

FIG. 48A is a perspective view of the drive assembly of FIGS. 45-48,shown with the collet tensioner arranged as depicted in FIG. 47A.

FIG. 48B is a perspective view of the drive assembly of FIGS. 45-48,shown with the collet tensioner arranged as depicted in FIG. 47B.

FIG. 49A is a perspective view of an end effector, according to aneighth embodiment of the present disclosure, which is likewiseconfigured for use with the surgical system of FIG. 1, the end effectorshown comprising a mount supporting a rotary instrument to generatetorque about a first axis, a drive assembly with a drive conduit tosupport a tool for rotation about a second axis coincident with thefirst axis, a trigger assembly coupled to the drive assembly, and aretention mechanism having guard cover arranged in a first guardposition.

FIG. 49B is another perspective view of the end effector of FIG. 49A,shown with the guard cover arranged in a second guard position, with theend effector arranged adjacent to two tools configured for releasableattachment to the drive assembly, with one of the tools shown as arotary cutting tool with a drill bit, and with the other of the toolsshown as an rotary driving tool supporting an anchor.

FIG. 50 is an exploded perspective view of the end effector of FIGS.49A-49B, shown with portions of the retention mechanism and the triggerassembly spaced from the mount and from an actuator subassembly.

FIG. 51 is an exploded perspective view of a portion of the actuatorsubassembly of FIG. 50.

FIG. 52 is an exploded perspective view of the trigger assembly of FIG.50, shown having a first trigger subassembly spaced from a secondtrigger subassembly.

FIG. 53A is an exploded perspective view of the second triggersubassembly of FIG. 52.

FIG. 53B is another exploded perspective view of the second triggersubassembly of FIG. 53A.

FIG. 54 is a partial, sectional perspective view of the second triggersubassembly of FIGS. 53A-53B, depicted as sectioned generallylongitudinally.

FIG. 55 is an exploded perspective view of the first trigger subassemblyof FIG. 52, shown having a guard locking subassembly to secure theretention mechanism of FIGS. 49A-50.

FIG. 56A is a partial perspective view of the end effector of FIGS.49A-50, shown with the guard cover of the retention mechanism secured inthe first guard position by the guard locking subassembly of FIG. 55.

FIG. 56B is another partial perspective view of the end effector of FIG.56A, shown with portions of the retention mechanism engaging portions ofthe guard locking subassembly.

FIG. 56C is a partial perspective view of the end effector of FIGS.49A-50, shown with the guard cover of the retention mechanism arrangedin the first guard position but disengaged from the guard lockingsubassembly of FIG. 55.

FIG. 56D is another partial perspective view of the end effector of FIG.56C, shown with portions of the retention mechanism disengaged from butadjacent to portions of the guard locking subassembly.

FIG. 57 is a partial, sectional perspective view of the end effector ofFIGS. 49A-50, depicted as sectioned generally longitudinally, shown withthe guard cover of the retention mechanism arranged in the second guardposition as depicted in FIG. 49B.

FIG. 58A is an enlarged, partial sectional perspective view taken alongindicia 58 of FIG. 57.

FIG. 58B is another enlarged, partial sectional perspective view of theend effector of FIG. 58A, shown with portions of the rotary driving toolof FIG. 49B supported in the drive conduit of the drive assembly.

FIG. 58C is another enlarged, partial sectional perspective view of theend effector and the rotary driving tool of FIG. 58B, shown with theguard cover of the retention mechanism arranged as depicted in FIGS.56C-56D.

FIG. 58D is another enlarged, partial sectional perspective view of theend effector and the rotary driving tool of FIG. 58C, shown with theguard cover of the retention mechanism arranged in the first guardposition as depicted in FIGS. 56A-56B.

FIG. 59A is an enlarged, partial sectional perspective view taken alongindicia 59 of FIG. 57.

FIG. 59B is another enlarged, partial sectional perspective view of theend effector of FIG. 59A, shown with portions of the rotary driving toolof FIG. 49B supported in the drive conduit of the drive assembly.

FIG. 60 is an exploded perspective view of the rotary driving tool andanchor of FIG. 49B, the rotary driving tool shown having a lockingsubassembly.

FIG. 61A is a partial, sectional perspective view of the rotary drivingtool of FIG. 60, depicted as sectioned generally longitudinally, shownwith the locking subassembly arranged in a driver locked configuration.

FIG. 61B is another partial, sectional perspective view of the rotarydriving tool of FIG. 61A, shown with the locking subassembly arranged ina driver unlocked configuration.

FIG. 62A is a partial, sectional perspective view of the rotary drivingtool of FIG. 60, depicted as sectioned along a plane (not shown)arranged about the second axis and disposed perpendicular to alongitudinal plane (not shown) likewise arranged about the second axis,shown with the locking subassembly arranged in a driver lockedconfiguration.

FIG. 62B is another partial, sectional perspective view of the rotarydriving tool of FIG. 61B, shown with the locking subassembly arranged ina driver unlocked configuration.

FIG. 63A is a partial perspective view of the end effector of FIGS.49A-50, shown with the guard cover of the retention mechanism arrangedin the first guard position, shown arranged adjacent to the rotarydriving tool of FIGS. 61A-62B, with the locking subassembly arranged inthe driver locked configuration to drive an anchor.

FIG. 63B is another partial perspective view of the end effector, therotary driving tool, and the anchor of FIG. 63A, shown with the rotarydriving tool supported in the drive conduit of the drive assembly asdepicted in FIG. 58B, and shown with the anchor arranged along thetrajectory.

FIG. 63C is another partial perspective view of the end effector, therotary driving tool, and the anchor of FIG. 63B, shown with the guardcover of the retention mechanism arranged in the second guard positionas depicted in FIG. 58D.

FIG. 63D is another partial perspective view of the end effector, therotary driving tool, and the anchor of FIG. 63C, shown with the guardcover of the retention mechanism arranged in the first guard position,shown with the locking subassembly of the rotary driving tool arrangedin the driver locked configuration, and shown with the anchor advancedalong the trajectory.

FIG. 63E is another partial perspective view of the end effector, therotary driving tool, and the anchor of FIG. 63D, shown with the lockingsubassembly of the rotary driving tool arranged in the driver lockedconfiguration.

FIG. 63F is another partial perspective view of the end effector, therotary driving tool, and the anchor of FIG. 63E, shown with the rotarydriving tool removed from the drive assembly of the end effector andreleased from the anchor, and shown with the anchor arranged along thetrajectory spaced from the end effector and from the rotary drivingtool.

It will be appreciated that one or more of the embodiments depictedthroughout the drawings may have certain components, structuralfeatures, and/or assemblies removed, depicted schematically, and/orshown in phantom for illustrative purposes.

DETAILED DESCRIPTION

Referring now to the drawings, wherein like numerals indicate like orcorresponding parts throughout the several views, a surgical system 30comprising a surgical robot 32 is shown in FIG. 1. The surgical robot 32has a base 34, a robotic arm 36, and a coupler 38. As is described ingreater detail below, the robotic arm 36 is supported by the base 34 andis configured to move, guide, drive, maintain, or otherwise control theposition and/or orientation of the coupler 38 relative to the base 34during use. The coupler 38 is adapted to releasably secure an endeffector 40 which, in turn, is configured to drive a tool, generallyindicated at 42, at a surgical site ST on a patient's body B along oneor more trajectories T, as is described in greater detail below. Thus,the surgical robot 32 moves the end effector 40 via the robotic arm 36to, among other things, assist medical professionals in carrying outvarious types of surgical procedures with precise control over movementand positioning of the end effector 40 and the tool 42. One exemplaryarrangement of the robotic arm 36 is described in U.S. Pat. No.9,119,655, entitled “Surgical Robotic arm Capable of Controlling aSurgical Instrument in Multiple Modes,” the disclosure of which ishereby incorporated by reference in its entirety. It will be appreciatedthat the robotic arm 36 and other portions of the surgical robot 32 maybe arranged in alternative configurations.

The surgical system 30 is configured to help a user (e.g., a surgeon)guide, position, and/or locate one or more types of tools 42, at and/orwith respect to the surgical site ST along the trajectory T maintainedby the surgical robot 32. As will be appreciated from the subsequentdescription below of the various embodiments of the present disclosure,tools 42 can be supported by the end effector 40 to, among other things,allow the surgeon to approach and manipulate anatomy of the patient'sbody B at the surgical site ST with a high level of control relative tothe trajectory T maintained by the surgical robot 32. Each of thecomponents of the surgical system 30 introduced above will be describedin greater detail below.

Those having ordinary skill in the art will appreciate that conventionalsurgical procedures routinely involve the use of a number of differenttypes of tools 42. Here, certain types of tools 42 can be characterizedas “active,” when configured to be driven by the end effector 40 whilebeing supported along the trajectory T (e.g., without limitation, rotarycutting instruments such as drills and burs). On the other hand, certaintypes of tools 42 can be characterized as “passive,” when configured tobe guided (but not necessarily driven) by the end effector 40 whilebeing at least partially supported along the trajectory T (e.g., withoutlimitation, dissectors and scalpels). In addition, some types of tools42 can be characterized as both “active” and “passive” depending on howthey are used, as will be appreciated from the subsequent descriptionbelow.

While a number of different types of “active” tools 42 are contemplatedby the present disclosure, two exemplary “active” tools 42 are describedherein in connection with FIGS. 4-5F: a rotary cutting tool 44 (e.g., arotary cutting instrument with a drill bit) to form a pilot hole 46along the trajectory T at the surgical site ST, and a rotary drivingtool 48 (e.g., an anchor driving instrument) configured to releasablysecure an anchor 50 (e.g., a polyaxial screw) that is adapted forinstallation along the trajectory T at the surgical site ST.

The representative embodiments of the end effectors 40 and tools 42described herein and illustrated in connection with the first embodimentof the end effector 40 are generally configured to assist surgeons inperforming various types of minimally-invasive spinal surgicalprocedures, such as posterior interbody spinal fusions of two or morevertebra in the patient's body B. However, as will be appreciated fromthe subsequent description below, the surgical system 30 can be used inconnection with a number of different types of surgical procedures whereit is advantageous to limit movement of tools 42 to rotation about andtranslation along an axial trajectory T, such as with “active” tools 42that are driven by the end effector 40 and/or with “passive” tools 42that are guided by the end effector 40. Here, the term “driven”generally corresponds to rotation of the tool 42 about the trajectory T.However, it will be appreciated that tools 42 supported by end effectors40 guided by surgical robots 32 can be driven in a number of differentways about and/or relative to the trajectory T and/or the surgical siteST, including without limitation: oscillation, reciprocation,translation, rotation, or combinations thereof.

As noted above, the illustrated surgical system 30 may advantageously beutilized in connection with minimally-invasive spinal surgicalprocedures such as posterior interbody spinal fusions. In thisillustrative example, the rotary cutting tool 44 can be used to formpilot holes 46 in different vertebrae, and the rotary driving tool 48can be used to install anchors 50 realized as pedicle screws intorespective pilot holes 46. Stabilization rods (not shown) may then bemounted between anchors 50 installed in pedicles of two or morevertebrae in the patient's body B to restrict relative movement betweenthose vertebrae and thereby help promote bone growth to fuse thevertebrae together. It will be appreciated that the forgoing example isillustrative, and that other types of surgical procedures arecontemplated.

In addition to forming pilot holes 46 for polyaxial pedicle-screw-typeanchors 50, the rotary cutting tool 44 may also form holes for othertypes of fixation hardware (e.g., pins, screws, brackets, plates, rods,and the like), prosthetic components (e.g., artificial joints, bonecages, implants, and the like), and/or medical devices (e.g., guidewires, instrumentation, sensors, trackers, and the like) in someembodiments. Furthermore, the rotary cutting tool 44 may also beconfigured to help remove portions of vertebra and/or adjacent tissue(e.g., as a bur utilized during a laminectomy or a discectomy) or otherbones (e.g., to facilitate grafting bone harvested from the iliac crest)in some embodiments. Thus, the tool 42 may be realized as a number ofdifferent types of surgical tools for cutting, removing, manipulating,or treating tissues at surgical sites, and the end effector 40 could beutilized in any suitable type surgical procedure where is advantageousto limit movement of the tool 42 to rotation about and translation alongthe trajectory T maintained by the surgical robot 32. Otherconfigurations, as noted above, are contemplated.

The surgical system 30 is able to monitor, track, and/or determinechanges in the relative position and/or orientation of one or more partsof the surgical robot 32, the robotic arm 36, the end effector 40,and/or the tool 42, as well as various parts of the patient's body B,within a common coordinate system by utilizing various types of trackers(e.g., multiple degree-of-freedom optical, inertial, and/or ultrasonicsensing devices), navigation systems (e.g., machine vision systems,charge coupled device cameras, tracker sensors, surface scanners, and/orrange finders), anatomical computer models (e.g., magnetic resonanceimaging scans of the lower lumbar region of the spine), data fromprevious surgical procedures and/or previously-performed surgicaltechniques (e.g., data recorded by the surgical robot 32 while formingthe pilot hole 46 that are subsequently used to facilitate installationof the anchor 50), and the like. To these ends, as is depictedschematically in FIG. 1, the surgical system 30 generally comprises acontrol system 52 and a navigation system 54 which cooperate to allowthe surgical robot 32 maintain alignment of the tool 42 along thetrajectory T. The control system 52 comprises an arm controller 56, andthe navigation system 54 comprises a navigation controller 58. Thecontrollers 56, 58 may be realized as computers, processors, controlunits, and the like, and may be discrete components, may be integrated,and/or may otherwise share hardware.

The surgical system 30 employs the control system 52 to, among otherthings, articulate the robotic arm 36, facilitate driving the tool 42,and the like. Here, the arm controller 56 of the control system 52 isconfigured to articulate the robotic arm 36 by driving variousactuators, motors, and the like disposed at joints of the robotic arm 36(not shown). The arm controller 56 also gathers sensor data from varioussensors such as encoders located along the robotic arm 36 (not shown).Because the specific geometry of each of the components of the surgicalrobot, end effector 40, and tool 42 are known, these sensor data can beused by the arm controller 56 to reliably adjust the position and/ororientation of the tool 42 within a manipulator coordinate system MNPL(see FIG. 1). The manipulator coordinate system MNPL has an origin, andthe origin is located relative to the robotic arm 36. One example ofthis type of manipulator coordinate system MNPL is described in U.S.Pat. No. 9,119,655, entitled “Surgical Robotic Arm Capable ofControlling a Surgical Instrument in Multiple Modes,” previouslyreferenced.

The surgical system 30 employs the navigation system 54 to, among otherthings, track movement of various objects such as the tool 42 and partsof the patient's body B (e.g., vertebrae located at the surgical siteST). To this end, the navigation system 54 comprises a localizer 60configured to sense the position and/or orientation of trackers 62 fixedto objects within a localizer coordinate system LCLZ. The navigationcontroller 58 is disposed in communication with the localizer 60 andgathers position and/or orientation data for each tracker 62 sensed bythe localizer 60 in the localizer coordinate system LCLZ.

It will be appreciated that the localizer 60 can sense the positionand/or orientation of multiple trackers 62 to track correspondinglymultiple objects within the localizer coordinate system LCLZ. By way ofexample, and as is depicted in FIG. 1, trackers 62 may comprise apointer tracker 62P, a tool tracker 62T, a first patient tracker 62A,and/or a second patient tracker 62B, as well as additional patienttrackers, trackers for additional medical and/or surgical tools, and thelike. In FIG. 1, the tool tracker 62T is firmly affixed to the endeffector 40, the first patient tracker 62A is firmly affixed to onevertebra at the surgical site ST (e.g., to S1 of the sacrum), and thesecond patient tracker 62B is firmly affixed to a different vertebra(e.g., to L5 of the lumbar spine). The tool tracker 62T could be fixedto the end effector 40 in different ways, such as by integration intothe end effector 40 during manufacture or by releasable attachment tothe end effector 40. The patient trackers 62A, 62B are firmly affixed todifferent bones in the patient's body B, such as by threaded engagement,clamping, or by other techniques. It will be appreciated that varioustrackers 62 may be firmly affixed to different types of tracked objects(e.g., discrete bones, tools, pointers, and the like) in a number ofdifferent ways.

The position of the trackers 62 relative to the anatomy to which theyare attached can be determined by known registration techniques, such aspoint-based registration in which the pointer tracker 62P (e.g., anavigation pointer) is used to touch off on bony landmarks on bone or totouch off on several points across the bone for surface-basedregistration. Conventional registration techniques can be employed tocorrelate the pose of the trackers 62 to the patient's anatomy (e.g.,each respective vertebra). Other types of registration are alsopossible, such as by using trackers 62 with mechanical clamps thatattach to the spinous process of the vertebra and have tactile sensors(not shown) to determine a shape of the spinous process to which theclamp is attached. The shape of the spinous process can then be matchedto a 3D model of the spinous process for registration. A knownrelationship between the tactile sensors and the three or more markerson the tracker 62 may be entered into or otherwise known by thenavigation controller 58. Based on this known relationship, thepositions of the markers relative to the patient's anatomy can bedetermined.

Position and/or orientation data may be gathered, determined, orotherwise handled by the navigation controller 58 using conventionalregistration/navigation techniques to determine coordinates of eachtracker 62 within the localizer coordinate system LCLZ. Thesecoordinates are communicated to the control system 52 to facilitatearticulation of the robotic arm 36, as described in greater detailbelow.

In the representative embodiment illustrated in FIG. 1, the armcontroller 56 is operatively attached to the surgical robot 32, and boththe navigation controller 58 and the localizer 60 are supported on amobile cart 64 which is movable relative to the base 34 of the surgicalrobot 32. The mobile cart 64 also supports a user interface, generallyindicated at 66, to facilitate operation of the surgical system 30 bydisplaying information to, and/or by receiving information from, thesurgeon or another user. The user interface 66 is disposed incommunication with the navigation system 54 and/or the control system52, and may comprise one or more output devices 68 (e.g., monitors,indicators, display screens, and the like) to present information to thesurgeon (e.g., images, video, data, a graphics, navigable menus, and thelike), and one or more input devices 70 (e.g., buttons, touch screens,keyboards, mice, gesture or voice-based input devices, and the like).One type of mobile cart 64 and user interface 66 is described in U.S.Pat. No. 7,725,162, entitled “Surgery System,” hereby incorporated byreference in its entirety.

Because the mobile cart 64 and the base 34 of the surgical robot 32 canbe positioned relative to each other and also relative to the patient'sbody B, the surgical system 30 transforms the coordinates of eachtracker 62 from the localizer coordinate system LCLZ into themanipulator coordinate system MNPL, or vice versa, so that articulationof the robotic arm 36 can be performed based at least partially on therelative positions and orientations of each tracker 62 within a single,common coordinate system (the manipulator coordinate system MNPL or thelocalizer coordinate system LCLZ). It will be appreciated thatcoordinates within the localizer coordinate system LCLZ can betransformed into coordinates within the manipulator coordinate systemMNPL, and vice versa, using a number of different conventionalcoordinate system transformation techniques.

In the illustrated embodiment, the localizer 60 is an optical localizerand includes a camera unit 72 with one or more optical position sensors74. The navigation system 54 employs the optical position sensors 74 ofthe camera unit 72 to sense the position and/or orientation of thetrackers 62 within the localizer coordinate system LCLZ. In therepresentative embodiment illustrated herein, the trackers 62 eachemploy active markers 76 (e.g., light emitting diodes “LEDs”), whichemit light that is sensed by the optical position sensors 74 of thecamera unit 72. One example of the navigation system 54 of this type isdescribed in U.S. Pat. No. 9,008,757, entitled “Navigation SystemIncluding Optical and Non-Optical Sensors,” the disclosure of which ishereby incorporated by reference in its entirety. In other embodiments,the trackers 62 may have passive markers, such as reflectors, whichreflect light emitted from the camera unit 72. It should be appreciatedthat other suitable tracking systems and methods not specificallydescribed herein may be utilized (e.g., ultrasonic, electromagnetic,radio frequency, and the like).

In some embodiments, the surgical system 30 is capable of displaying avirtual representation of the relative positions and orientations oftracked objects to the surgeon or other users of the surgical system 30,such as with images and/or graphical representations of the vertebraeand the tool 42 presented on one or more output devices 68 (e.g., adisplay screen). The arm controller 56 and/or navigation controller 58may also utilize the user interface 66 to display instructions orrequest information such that the surgeon or other users may interactwith the control system 52 to facilitate articulation of the robotic arm36. Other configurations are contemplated.

It will be appreciated that the control system 52 and the navigationsystem 54 can cooperate to facilitate control over the position and/ororientation of the tool 42 in different ways. By way of example, in someembodiments, the arm controller 56 is configured to control the roboticarm 36 (e.g., by driving joint motors) to provide haptic feedback to thesurgeon via the robotic arm 36. Here, haptic feedback help constrain orinhibit the surgeon from manually moving the end effector 40 and/or tool42 beyond predefined virtual boundaries associated with the surgicalprocedure (e.g., to maintain alignment of the tool 42 along thetrajectory T). One type of haptic feedback system and associated hapticobjects that define virtual boundaries are described, for example, inU.S. Pat. No. 8,010,180, entitled “Haptic Guidance System and Method,”the disclosure of which is hereby incorporated by reference in itsentirety. In one embodiment, the surgical system 30 is the RIO™ RoboticArm Interactive Orthopedic System manufactured by MAKO Surgical Corp. ofFort Lauderdale, Fla., USA.

Referring now to FIGS. 1-11F, as noted above, the surgical system 30employs the end effector 40 to drive the tool 42 at the surgical site STalong different trajectories T maintained by the surgical robot 32 toassist the surgeon in carrying out various types of surgical procedureswith precise control over the relative position and orientation of thetool 42 with respect to the patient's body B.

As is best depicted in FIGS. 3-4, the end effector 40 generallycomprises a mount 78 which is adapted to attach to the coupler 38 of therobotic arm 36 of the surgical robot 32 for concurrent movementtherewith (see FIG. 1). A rotary instrument, generally indicated at 80,is coupled to the mount 78 and is configured to selectively generaterotational torque about a first axis A1 as described in greater detailbelow. A drive assembly 82 is provided with a geartrain 84 to translaterotation from the rotary instrument 80 about the first axis A1 intorotation about a second axis A2 different from the first axis A1. In therepresentative embodiment illustrated in connection with the firstembodiment of the end effector 40, the second axis A2 intersects and issubstantially perpendicular to the first axis A1. However, it will beappreciated that other arrangements of the axes A1, A2 are contemplated.The drive assembly 82 is also provided with a connector, generallyindicated at 86, which is configured to releasably secure differenttypes of tools 42 for rotation about the second axis A2. A triggerassembly, generally indicated at 88, is provided with a grip 90 tosupport a user's hand (e.g., the surgeon's hand), and an input trigger92 in communication with the rotary instrument 80. The input trigger 92is arranged for selective engagement by the user to drive the rotaryinstrument 80 and rotate the tool 42 about the second axis A2 atdifferent rotational speeds. The end effector 40 also comprises a manualinterface, generally indicated at 94, to communicate with the driveassembly 82 and to receive and translate applied force from the userinto rotational torque to rotate the tool 42 about the second axis A2.To this end, and as is shown in FIGS. 3, 4, 10B, and 11B-11C, a manualhandle assembly 96 is provided in the illustrated embodiments forreleasable attachment to the manual interface 94. The manual interface94 and the handle assembly 96 afford the surgeon with the ability tocarry out manually-driven operations (e.g., manual drilling, screwdriving, and the like) in combination with power-driven operations(e.g., powered drilling, screw driving, and the like) via torque fromthe rotary instrument 80. Thus, depending on the specific procedurebeing performed, the types of tools 42 being utilized in the procedure,the preferences of the surgeon, and the like, certain steps of thesurgical procedure can be powered via the rotary instrument 80, andother steps can be carried out manually via the handle assembly 96. Eachof the components of and for use with the end effector 40 introducedabove will be described in greater detail below.

Minimally-invasive spinal fusion techniques (as well as other types ofsurgical procedures) generally involve installing multiple anchors 50 intwo or more vertebra at the surgical site ST. For example, in aposterior lumbar interbody fusion of two adjacent vertebrae (e.g., afusion of S1 of the sacrum to L5 of the lumbar spine), anchors 50 aretypically installed bilaterally into the pedicles on both sides of thespinous process of each vertebra to be fused to support correspondinglybilateral stabilization rods. Thus, fusing two adjacent vertebraegenerally involves installing at least four anchors 50, and eachadditional vertebrae to be fused generally involves installing anothertwo bilateral anchors 50 (e.g., a fusion of S1 of the sacrum to L5 ofthe lumbar spine combined with a fusion of L5 of the lumbar spine to L4of the lumbar spine). Moreover, those having ordinary skill in the artwill appreciate that anchors 50 must be installed into vertebraecarefully with respect to the spinal cord, nerve roots, and the like,such as to extend entirely through the respective pedicle, from adjacentthe lamina into the vertebral body, without passing through the foramen.Thus, as shown in FIGS. 2A-2C, each anchor 50 is installed along adifferent trajectory T.

FIGS. 5A-5G each transversely depict a vertebra (e.g., L5 of the lumbarspine) and sequentially illustrate how tools 42 supported by the endeffector 40 can be utilized to facilitate installation of anchors 50 viathe rotary instrument 80 and, in some embodiments, the manual interface94. In FIG. 5A, first and second trajectories T1, T2 are shown arrangedbilaterally relative to the spinous process, each extending through therespective pedicles into the vertebral body on opposing sides of theforamen and spinal cord. One anchor 50 is shown already installed alongthe first trajectory T1, and a distal cutting end 44D of the rotarycutting tool 44 (e.g., a drill bit tip) is shown adjacent to thesurgical site ST. Here, the rotary cutting tool 44 is supported forrotation about the second axis A2, and the surgical robot 32 maintainsalignment of the second axis A2 with the second trajectory T2.

FIG. 5B shows the rotary cutting tool 44 advanced along the secondtrajectory T2 through the pedicle to position the distal cutting end 44Dat a first depth D1 into the vertebra at the surgical site ST, and FIG.5C shows the rotary cutting tool 44 advanced even further along thesecond trajectory T2 to position the distal cutting end 44D at a seconddepth D2 greater than the first depth D1.

FIG. 5D shows the pilot hole 46 formed by the rotary cutting tool 44which extends into the vertebra along the second trajectory T2 to thesecond depth D2. FIG. 5D also shows a distal tip 50D of another anchor50 positioned adjacent to the surgical site ST to be installed in thepilot hole 46. Here, the anchor 50 is supported by the rotary drivingtool 48 for rotation about the second axis A2 (see FIGS. 3-4), and thesurgical robot 32 similarly maintains alignment of the second axis A2with the second trajectory T2.

FIG. 5E shows the anchor 50 advanced along the second trajectory T2after having been “threaded” into the pilot hole 46 via rotation of therotary driving tool 48 about the second axis A2. Here in FIG. 5E, thedistal tip 50D of the anchor 50 is positioned at a third depth D3 intothe vertebra, which is greater than the second depth D2 in this examplebut could be the same as or less than the second depth D2.

In FIG. 5F, the anchor 50 is shown advanced even further along thesecond trajectory T2 to position the distal tip 50D at a fourth depth D4greater than the third depth D3. Here, the fourth depth D4 representsthe intended final position FP of the installed anchor 50, and the finalpositions FP of both bilateral anchors are shown in FIG. 5G, with eachanchor 50 aligned to its respective trajectory T1, T2.

With continued reference to FIGS. 5A-5G, it will be appreciated that thesurgeon can advance the rotary cutting tool 44 or the rotary drivingtool 48 along the second trajectory T2 in a number of different ways.Because of the how the illustrated rotary cutting tool 44 and rotarydriving tool 48 are configured, rotation of the tools 42 about thesecond axis A2 tends to advance the distal cutting end 44D and/or thedistal tip 50D along the second trajectory T2 in response to engagementwith bone. Irrespective of this tendency, the surgeon generally advancesthe tools 42 along the second trajectory T2 by applying force to thegrip 90 of the trigger assembly 88 while operating the surgical robot 32in a haptic mode to inhibit movement or articulation of the robotic arm36 which might otherwise bring the second axis A2 out of alignment withthe second trajectory T2.

In some embodiments, the surgical system 30 is configured to operate indifferent ways as one or more of the depths D1, D2, D3, D4 areapproached or reached. For example, the surgical system 30 could beconfigured to allow the surgeon to engage the input trigger 92 to drivethe rotary instrument 80 to rotate the rotary cutting tool 44 about thesecond axis A2 until the first depth D1 is reached (see FIG. 5B). Oncethe first depth D1 is reached, the surgical system 30 could interruptrotation to, among other things, allow the surgeon to advance from thefirst depth D1 to the second depth D2 (see FIG. 5C) manually (e.g.,without torque from the rotary instrument 80) via engagement of thehandle assembly 96 with the manual interface 94.

The surgical system 30 could similarly interrupt rotation as the anchor50 is installed, such as when the distal tip 50D reaches the third depthD3 (see FIG. 5E) so that the surgeon can complete installation from thethird depth D3 to the fourth depth D4 (see FIG. 5F) manually viaengagement of the handle assembly 96 with the manual interface 94. Inaddition to interrupting rotation at predetermined depths, the surgicalsystem 30 could also slow rotation as certain depths are approached,restrict translation speed along the second trajectory T2, or otherwiseafford variable control over rotation and/or translation of the tools42.

The installation sequence illustrated in FIGS. 5A-5G is intended to beexemplary and non-limiting, and the depths D1, D2, D3, D4 are intendedto be arbitrary reference points to help describe how the tools 42 canbe utilized, but could also represent actual depths into the vertebra(e.g., determined and set according to a pre-surgical plan).Furthermore, while the forgoing discussion of the depths D1, D2, D3, D4in connection with FIGS. 5A-5G generally differentiates between rotatingthe tools 42 with the rotary instrument 80 until one depth is reached(e.g., D1 or D3) before rotating the tools 42 with the manual interface94 to a final depth (e.g., D2 or D4), it is conceivable that the rotaryinstrument 80 or the manual interface 94 could be utilized alone torotate tools 42 to the final depths (e.g., D2 or D4) in someembodiments. By way of illustrative example, the rotary instrument 80could be used to drive the rotary cutting tool 44 to form the pilot holeall the way to the second depth D2 (and could slow rotation from thefirst depth D1 to the second depth D2), at which point the surgicalsystem 30 could interrupt rotation of the rotary instrument 80 to promptthe surgeon to switch to the rotary driving tool 48 to install theanchor 50. The rotary driving tool 48 could then be rotated manually viathe manual interface 94 all the way to the fourth depth D4 without usingtorque from the rotary instrument 80. Put differently, it is conceivablethat certain tools 42 could be rotated exclusively via torque generatedby the rotary instrument 80, exclusively via torque applied manually tothe manual interface 94, or sequentially from both the rotary instrument80 and the manual interface 94. Other configurations are contemplated.

It will be appreciated that the workflow associated with installation ofthe anchor 50 could vary from the exemplary embodiments described hereinbased, among other things, on the specific surgical procedure beingperformed, the configuration of the anchor 50, and the like. By way ofnon-limiting example, instead of forming the pilot hole 46 to helpfacilitate installation of the anchor 50 illustrated throughout thedrawings, it is contemplated that the anchor 50 could be configured tofacilitate a “single-pass” workflow without necessarily requiringformation of the pilot hole 46, such as with anchors 50 that are“self-tapping” or otherwise configured so as to be installed withoutrequiring a pre-formed pilot hole 46. Other configurations arecontemplated.

Referring now to FIGS. 6-9, the rotary driving tool 48 and anchor 50 areshown in greater detail. As noted above, the illustrated anchor 50 isrealized as a pedicle screw implant configured for installation into avertebra in minimally-invasive surgical techniques, and has a threadedbody 98 supported by a polyaxial head 100 to which blades 102 aredetachably secured.

An exemplary embodiment of the construction of this type of anchor 50 isdescribed in U.S. Pat. No. 9,408,716, entitled “Percutaneous PosteriorSpinal Fusion Implant Construction and Method,” the disclosure of whichis hereby incorporated by reference in its entirety. In someembodiments, the surgical system 30 may facilitate installation of thisor other types of anchors 50 as described in U.S. Pat. No. 9,801,686,entitled “Neural Monitor Based Dynamic Haptics,” and/or U.S. PatentApplication Publication No. US 2018/0042650 A1, entitled “Power PedicleScrewdriver,” the disclosures of which are each hereby incorporated byreference in their entirety. It will be appreciated that other types andconfigurations of anchors 50, and the associated installation thereof,are contemplated by the present disclosure.

As is best illustrated in FIG. 9, the rotary driving tool 48 generallycomprises a driveshaft 104 which is rotatably supported within a supporttube 106. A contoured body 108 is coupled to the support tube 106 forconcurrent rotation and is configured for engagement by the surgeon to,among other things, facilitate attaching the rotary driving tool 48 tothe anchor 50. The contoured body 108 selectively engages a lockingsubassembly 110 for concurrent rotation via splined engagement,generally indicated at 112.

The locking subassembly 110 is configured to selectively restrict axialmovement of the driveshaft 104 relative to the support tube 106. To thisend, the locking subassembly 110 comprises a locking body 114 thatsupports a slider 116 for movement transverse to the driveshaft 104. Theslider 116 is biased by a spring 118 and is retained relative to thelocking body 114 via a pin 119 in the illustrated embodiment. Thesupport tube 106 comprises external threads 120 which engagecorresponding internal threads 122 formed in the blades 102 of theanchor 50, and a distal end of the driveshaft 104 comprises a driver key124 which engages a correspondingly-shaped driven key 126 formed in theproximal end of the threaded body 98 of the anchor 50 adjacent to thepolyaxial head 100. The rotary driving tool 48 is thus releasablyattachable to the anchor 50 via engagement between the driver key 124and the driven key 126 and via engagement between the external threads120 and the internal threads 122. One exemplary embodiment of this typeof rotary driving tool 48 and anchor 50 are described in U.S. Pat. No.8,002,798, entitled “System and Method for Spinal Implant Placement,”the disclosure of which is hereby incorporated by reference in itsentirety.

A bit interface, generally indicated at 128, is coupled to the proximalend of the driveshaft 104 adjacent to the locking subassembly 110. Thebit interface 128 is configured to be releasably attached to theconnector 86 of the drive assembly 82 of the end effector 40 andcomprises an axial retainer 130 and a rotational retainer 132 whichengage to connector 86 to restrict translation and rotation,respectively, of the rotary driving tool 48 relative to the connector86, as described in greater detail below. As is best depicted in FIG. 8,the threaded body 98 of the anchor 50, as well as the driveshaft 104 andbit interface 128 of the rotary driving tool 48, are cannulated to,among other things, allow a guidewire GW (e.g., a “K-Wire”) to extendtherethrough (not shown in detail).

Referring now to FIGS. 1-24, as noted above, the end effector 40 isconfigured to facilitate rotation of the tool 42 about the second axisA2 via torque from either the rotary instrument 80 or the manualinterface 94 as the surgical robot 32 maintains alignment of the secondaxis A2 with the trajectory T and allows the end effector 40 and thetool 42 to concurrently translate along the second axis A2, such as inresponse to force applied by the surgeon to the grip 90 of the triggerassembly 88. As is best depicted in FIGS. 10A-12, the mount 78 isconfigured to support the various other components of the end effector40 to advantageously position the second axis A2 relative to the coupler38 of the robotic arm 36 (see FIG. 1) to, among other things, promoterigidity and stiffness of the end effector 40 while, at the same time,affording advantages relating to the usability, stability, and accuracyof the surgical system 30.

In the representative embodiment of the trigger assembly 88 illustratedin connection with the first embodiment of the end effector 40, the grip90 has a generally cylindrical profile and is configured for generallypronate or supernate hand engagement. Thus, when the surgeon isactuating the trigger assembly 88 to generate torque with the rotaryinstrument 80, the surgeon's hand is positioned above the drive assembly82 such that the second axis A2 generally extends through the grip 90(see FIGS. 10A and 11A). This advantageously allows the surgeon's handto be positioned along the trajectory T while the trigger assembly 88 isbeing engaged, which can help the surgeon to apply force to the endeffector 40 in a direction substantially aligned with the trajectory Tto advance the tool 42. Furthermore, this configuration allows thesurgeon to engage the grip 90 without substantially obstructing thesurgeon's view of the drive assembly 82, the tool 42, or the surgicalsite ST. However, it will be appreciated that the trigger assembly 88and/or grip 90 could be configured in other ways, such as where the grip90 is shaped and arranged for generally neutral (as opposed to pronateor supernate) hand engagement, and could be arranged either in-line withor offset from the trajectory T when engaged to drive the rotaryinstrument 80. Other configurations are contemplated.

While the illustrated embodiment of the trigger assembly 88 depictedthroughout the drawings advantageously positions the surgeon's handalong the trajectory T when the grip 90 is engaged to drive the rotaryinstrument 80 as noted above (see FIGS. 10A and 11A), it will beappreciated that this configuration necessarily positions the grip 90 ina way that at least partially inhibits access to the manual interface94. In order to promote access to the manual interface 94, the triggerassembly 88 comprises a frame, generally indicated at 134, whichsupports the grip 90 and the input trigger 92 for movement relative tothe rotary instrument 80 between a plurality of trigger assemblypositions including a first trigger assembly position P1 where the grip90 and the input trigger 92 are arranged for engagement by the surgeonto drive the rotary instrument 80 to rotate the tool 42 about the secondaxis A2 (see FIGS. 10A, 11D, 11E, and 19A-19B), and a second triggerassembly position P2 where the grip 90 and the input trigger 92 arepositioned so as to promote access to the manual interface 94 which isthereby arranged to receive applied force from the user to rotate thetool 42 about the second axis A2 (see FIGS. 10B and 11B-11C). As isdescribed in greater detail below, other trigger assembly positions arecontemplated.

As is best depicted in FIGS. 15, 17, and 19A-19C, the trigger assembly88 comprises a retainer, generally indicated at 136, which isoperatively coupled to the frame 134 for concurrent movement. In theillustrated embodiment, the retainer 136 is formed as a separatecomponent from the frame 134 to facilitate assembly of the end effector40, but could be formed integrally with the frame 134 in otherembodiments.

The retainer 136 is configured to prevent the grip 90 of the triggerassembly 88 from inadvertently moving relative to the rotary instrument80. To this end, the retainer 136 comprises a plunger 138 which isselectively movable between a locked position 138L (see FIG. 20A; seealso FIG. 15) and an unlocked position 138U (see FIG. 20B). A catch,generally indicated at 140, is operatively attached to the rotaryinstrument 80 (e.g., via fasteners) and has a plurality of receptacles141 each shaped to receive the plunger 138 of the retainer 136 in thelocked position 138L to define one of the trigger assembly positions P1,P2. As is best depicted in FIGS. 19A-19C, the catch 140 has a generallyannular profile, and the receptacles 141 each have a generallycylindrical profile and are radially spaced from each other about thecatch 140. It will be appreciated that the arrangement of the retainer136 and the catch 140 could be interchanged such that the plunger couldremain stationary relative to the rotary instrument 80 instead of movingconcurrently with the trigger assembly 88.

Referring now to FIGS. 15 and 20A-20B, the retainer 136 comprises arelease lever 142 in communication with the plunger 138. The releaselever 142 is arranged for engagement by the surgeon or another user tofacilitate movement of the plunger 138 between the locked position 138L(see FIG. 20A) and the unlocked position (see FIG. 20B). The plunger 138is supported for movement along a plunger bore 144 formed in theretainer 136, and is coupled to the release lever 142 via a lever guidepin 146 which, in turn, is supported for translation along a retainerslot 148 (depicted in phantom in FIGS. 20A-20B) formed in the retainer136. A plunger biasing element 150 (see FIG. 15), such as a compressionspring, is interposed between the plunger 138 and the retainer 136 tourge the plunger 138 into the locked position 138L. In order to move theplunger 138 to the unlocked position 138U, the release lever 142supports a clasp element 152 which can be selectively positioned into acorrespondingly-shaped clasp pocket 154 formed in the retainer 136. Theclasp element 152 is attached to the release lever 142 via a clasp pin156.

In order to move to the plunger 138 to the unlocked position 138U, thesurgeon or another user can apply force to the release lever 142 in adirection generally away from the catch 140 to compress the plungerbiasing element 150 as the lever guide pin 146 translates along theretainer slot 148 until the clasp element 152 is placed into the clasppocket 154. The corresponding shapes of the clasp element 152 and theclasp pocket 154 keep the plunger 138 in the unlocked position 138Uuntil the surgeon or another user subsequently applies force to therelease lever 142 in a direction generally toward the catch 140 toremove the clasp element 152 from the clasp pocket 154, whereby energystored in the plunger biasing element 150 then returns the plunger 138to the locked position 138L. It will be appreciated that otherconfigurations of the retainer 136, the plunger 138, and the catch 140are contemplated.

As shown in FIG. 17, the rotary instrument 80 comprises a journal,generally indicated at 158, and the trigger assembly 88 comprises abearing surface 160 operatively attached to the frame 134 which isdisposed in engagement with the journal 158 such that the triggerassembly 88 is selectively movable relative to the rotary instrument 80between the trigger assembly positions P1 (see FIGS. 10A, 11A, and19A-19B), P2 (see FIGS. 10B and 11B-11C), P3 (see FIGS. 11F and 19C)about a trigger axis A3 (see FIGS. 19A-19C). Put differently, in theillustrated embodiment, the frame 134 supports the trigger assembly 88for rotational movement relative to the rotary instrument 80 between thetrigger assembly positions P1, P2, P3. As shown in FIG. 17, the bearingsurface 160 is defined by a cap element 162 that attaches to the frame134 via fasteners, as well as by a portion of the frame 134 adjacent tothe cap element 162. Other journals and bearing surfaces may be providedat other locations along the rotary instrument 80 and trigger assembly88, respectively, to promote smooth rotational movement therebetween(e.g., adjacent to the retainer 136). While the illustrated embodimentis directed toward rotational movement of the trigger assembly 88between the first and second trigger assembly positions P1, P2, it willbe appreciated that other types of movement are contemplated. By way ofillustrative example, pivoting movement, sliding movement, translation,and/or combinations thereof could be utilized in some embodiments.

As noted above, the grip 90 of the trigger assembly 88 is arranged inthe illustrated embodiment to support the surgeon's hand along thetrajectory T as the surgeon engages the input trigger 92 to drive therotary instrument 80. In one embodiment, the second axis A2 intersectsat least a portion of the trigger assembly 88 in the first triggerassembly position P1 (see FIG. 10A). Furthermore, as shown in FIG. 11A,when the trigger assembly 88 is in the first trigger assembly positionP1, the grip 90 is substantially perpendicular to the second axis A2.Conversely, and as shown in FIG. 11B, when the trigger assembly 88 is inthe second trigger assembly position P2, the grip 90 is substantiallyparallel to (and offset from) the second axis A2. Thus, movement fromthe first trigger assembly position P1 to the second trigger assemblyposition P2 comprises rotating the trigger assembly 88 approximately90-degrees relative to the rotary instrument 80 in the illustratedembodiment. Thus, as shown in FIGS. 19A-19C, the receptacles 141 of thecatch 140 which define the first and second trigger assembly positionsP1, P2 are arranged 90-degrees apart from each other relative to thetrigger axis A3. Furthermore, additional receptacles 141 are provided todefine other trigger assembly positions, such as a third triggerassembly position P3 (see FIGS. 11F and 19C) between the first andsecond trigger assembly positions P1, P2. It will be appreciated thatany suitable number of receptacles 141 could be provided to define acorresponding number of discrete trigger assembly positions spaced fromeach other in a number of different ways.

As is depicted schematically in FIG. 16, in one embodiment the endeffector 40 is provided with an assembly sensor arrangement, generallyindicated at 164, interposed between the rotary instrument 80 and thetrigger assembly 88 to determine a position of the trigger assembly 88relative to the rotary instrument 80 between the trigger assemblypositions P1, P2, P3 (see FIGS. 11A, 11B, and 11F). The assembly sensorarrangement 164 may be of any suitable configuration sufficient todifferentiate between positions (e.g., an encoder, a sensor/emitterarrangement, and the like), and may communicate with the control system52 to, among other things, allow the rotary instrument 80 to becontrolled in different ways depending on how the trigger assembly 88 ispositioned relative to the rotary instrument 80. Other configurationsand arrangements are contemplated.

As noted above, the input trigger 92 of the trigger assembly 88 isarranged for engagement by the surgeon to facilitate driving the rotaryinstrument 80. As is depicted generically in FIG. 13, the rotaryinstrument 80 comprises an actuator 166 (e.g., an electric motor) whichis supported within an instrument housing 168 which, in turn, definesthe journal 158 and rigidly attaches to the mount 78. The actuator 166is disposed in communication with an actuator driver, generallyindicated at 170 (e.g., a motor controller supported on a printedcircuit board) which, in turn, is disposed in communication with thecontrol system 52 via an actuator interface, generally indicated at 172(e.g., a wiring harness connected to the arm controller 56). Thosehaving ordinary skill in the art will appreciate that the actuator 166,the actuator driver 170, and/or the actuator interface 172 could bearranged or configured in a number of different ways sufficient topower, control, or otherwise enable the rotary instrument 80 toselectively generate rotational torque about the first axis A1 inresponse to engagement of the input trigger 92. Furthermore, and as willbe appreciated from the subsequent description below, certainembodiments of the end effector 40 illustrated in connection with thefirst embodiment of the end effector 40 and described herein areconfigured such that rotary instrument 80 has a generally modularconfiguration (e.g., removable from one or more portions of the driveassembly 82), while other embodiments of the end effector 40 are lessmodular (e.g., integrated with one or more portions of the driveassembly 82). Thus, unless otherwise indicated, the terms “actuator 166”and “rotary instrument 80” may be used interchangeably.

Referring now to FIGS. 13-19C, the input trigger 92 of the triggerassembly 88 is disposed in communication with the actuator driver 170 tofacilitate how rotational torque is generated by the actuator 166. Tothis end, the input trigger 92 is arranged for movement relative to thegrip 90 between a first input position I1 (see FIG. 19A) and a secondinput position I2 (see FIG. 19B) to control rotational torque generatedby the rotary instrument 80. In the illustrated embodiment, the firstinput position I1 corresponds to an absence of engagement with the inputtrigger 92, and the second input position I2 corresponds to fullengagement of the input trigger 92. It will be appreciated that theinput trigger 92 is also movable to other input positions between thefirst and second input positions I1, I2, such as to facilitate variablespeed control of the actuator 166.

In order to communicate the physical position of the input trigger 92between the first and second input positions I1, I2 to the actuatordriver 170, the trigger assembly 88 comprises a trigger emitter 174 (seeFIGS. 17-19C) disposed in communication with the input trigger 92, andthe rotary instrument 80 comprises a trigger detector 176 (see FIGS.17-18; depicted schematically) disposed in communication with theactuator driver 170 to determine a position of the trigger emitter 174corresponding to movement of the input trigger 92 between the first andsecond input positions I1, I2. In one embodiment, the trigger emitter174 is further defined as a magnet, and the trigger detector 176 isresponsive to predetermined changes in magnetic fields generated by themagnet to determine the relative position of the trigger emitter 174. Inthis illustrative example, the trigger detector 176 may be of anysuitable type sufficient to sense and respond to changes in magneticfields. Moreover, it is conceivable that the trigger emitter 174 couldbe manufactured from an iron-based material and the trigger detector 176could be a hall-effect sensor that responds to changes in magneticfields due to interaction of the iron-based material of the triggeremitter 174. Thus, it is conceivable that the trigger emitter 174 mayalso be realized as a ferrous enamel, coating, paint, or the like. Otherconfigurations are contemplated.

Referring now to FIGS. 17-19C, a linkage 178 is interposed between theinput trigger 92 and the trigger emitter 174 to translate movement ofthe input trigger 92 between the first and second input positions I1, I2into corresponding movement of the trigger emitter 174 which can besensed by the trigger detector 176. The linkage 178 generally comprisesa cam member 180, a piston 182, a carrier 184, a fork 186, and a forkguide 188. The input trigger 92, in turn, comprises a trigger handle190, a pair of guide shafts 192, and an extension member 194. The guideshafts 192 extend from the trigger handle 190 and are supported forsliding movement within respective bushings 196 disposed in the grip 90.The extension member 194 similarly extends from the trigger handle 190,away from the guide shafts 192, to a notched end 198. The cam member 180is interposed between the piston 182 and the notched end 198 of theinput trigger 92, and pivots about a support shaft 200 which is coupledto the frame 134. On opposing sides of the support shaft 200, the cammember 180 has an engagement face 202 which abuts the piston 182, and aslotted projection 204 in which an extension pin 206 travels. Theextension pin 206 is attached to the notched end 198 of the extensionmember 194 to pivot the cam member 180 about the support shaft 200 asthe input trigger 92 moves.

The piston 182 is slidably supported in a piston bushing 208 attached tothe frame 134. In addition to contacting the engagement face 202 of thecam member 180, the piston 182 also contacts a fork guide shaft 210 ofthe fork guide 188 which, in turn, supports a trigger biasing element212 between a pair of washers 214 and a keeper 216 (see FIG. 18). Thekeeper 216 attaches to the fork guide shaft 210 and engages one of thewashers 214 to retain the trigger biasing element 212 between thewashers 214. The washers 214 help facilitate translation of the forkguide shaft 210 in response to movement of the piston 182. Here, thetrigger biasing element 212 is arranged to compress between one of thewashers 214 and the frame 134 as the input trigger moves from the firstinput position I1 to the second input position I2, and energy stored inthe trigger biasing element 212 urges the input trigger toward the firstinput position I1.

The fork guide 188 moves concurrently with the fork 186 which, in theillustrated embodiment, is disposed within the retainer 136 fortranslation along the first axis A1 as the input trigger 92 movesbetween the first and second input positions I1, I2 (compare FIG. 19Awith FIG. 19B). As shown in FIG. 17, the retainer 136 is shaped torotate concurrently with the fork 186 about the first axis A1 as thetrigger assembly 88 moves between the first and second trigger assemblypositions P1, P2.

The carrier 184 is operatively attached to or otherwise supports thetrigger emitter 174 for concurrent movement, and defines an outersliding contact surface 218 (see FIG. 18) and a pair of outer blockingsurfaces 220. The fork 186, in turn, defines an inner sliding contactsurface 222 and a pair of inner blocking surfaces 224. The outer slidingcontact surface 218 of the carrier 184 engages the inner sliding contactsurface 222 of the fork 186 to permit rotational movement of the fork186 about the first axis A1 without moving the carrier 184, and theouter blocking surfaces 220 of the carrier 184 engage the inner blockingsurfaces 224 of the fork 186 to facilitate concurrent translation of thefork 186 and the carrier 184 along the first axis A1 (compare FIGS.19A-19C). As shown in FIG. 18, the instrument housing 168 of the rotaryinstrument 80 defines a slot 226 which is arranged adjacent to thetrigger detector 176 (depicted schematically in FIG. 18). The carrier184 comprises a boss 228 which is supported along the slot 226 fortranslation in response to corresponding translation of the fork 186along the first axis A1 effected by movement of the input trigger 92between the first and second input positions I1, I2. It will beappreciated that other configurations beyond those illustrated in thedrawings are contemplated for the various components of the linkage 178and/or the trigger assembly 88.

Referring again to FIGS. 1-24, the end effector 40 employs a coupling230 operatively attached to the rotary instrument 80. The coupling 230is configured to releasably secure the drive assembly 82 to the rotaryinstrument 80 in a plurality of orientations to selectively position thesecond axis A2 relative to the rotary instrument 80 along differenttrajectories maintained by the surgical robot 32. This functionalityaffords the surgeon with a more consistent approach along each discretetrajectory T in that the grip 90 can generally be positioned similarlyirrespective of how the second axis A2 is orientated relative to therotary instrument 80 and, thus, relative to the mount 78 of the endeffector 40 (compare FIGS. 2A-2C).

The functionality described above is further illustrated throughoutFIGS. 11A-11F by comparing the orientation of the second axis A2 withthe orientation of the mount 78. Here, the mount 78 has a referenceportion, generally indicated at 232, which in this illustrative exampleis realized as a vertical line defined by a generally planar face of themount 78 which abuts the coupler 38 of the robotic arm 36. However, itwill be appreciated that the reference portion 232 could be defined byother components of the end effector 40 which remain fixed relative tothe mount 78, or could be defined in other ways (e.g., vertically withrespect to the environment, such as by gravity).

In FIGS. 11A-11C, the drive assembly 82 is arranged in a referenceorientation OR defined between the second axis A2 and the referenceportion 232 of the mount 78. Thus, the second axis A2 is parallel withthe reference portion 232 when in the reference orientation OR. In FIG.11D, however, the drive assembly 82 is arranged in a different, firstorientation O1 defined by rotation of the drive assembly 82 relative tothe rotary instrument 80 about the first axis A1 in a first rotationaldirection R1. Moreover, in FIGS. 11E and 11F, the drive assembly 82 isarranged in a second orientation O2 defined by rotation of the driveassembly 82 relative to the rotary instrument 80 about the first axis A1in an opposite, second rotational direction R2.

From the perspective depicted in FIGS. 11A-11F, the first rotationaldirection R1 is counter-clockwise and the second rotational direction R2is clockwise. Thus, when in the first orientation O1 depicted in FIG.11D, the drive assembly 82 has been rotated counter-clockwise about thefirst axis A1 +45-degrees relative to the reference portion 232. When inthe second orientation O2 depicted in FIGS. 11E-11F, the drive assembly82 has been rotated clockwise about the first axis A1 −45-degreesrelative to the reference portion 232. As such, there is a 90-degreedifference between the first orientation O1 and the second orientationO2. However, it will be appreciated that the first and secondorientations O1, O2 could be defined in a number of different ways tofacilitate consistent positioning of the grip 90. Moreover, it will beappreciated that the coupling 230 could support the drive assembly 82 inother orientations.

Referring now to FIG. 13, in the representative embodiment illustratedherein, the coupling 230 comprises a plurality of coupling elements 234(e.g., ball bearings) which are supported for radial movement relativeto the first axis A1 along respective coupling pockets 236 formed in acarrier ring 238. The coupling 230 also comprises a lock collar 240 withan inner ramp surface 242 that contacts the coupling elements 234. Thelock collar 240 is arranged for selective rotation about the first axisA1 via force applied thereto from the surgeon. The carrier ring 238 isconfigured to translate axially relative to the rotary instrument 80 inresponse to rotation of the lock collar 240 relative to the instrumenthousing 168, such as via threaded engagement between the lock collar 240and the carrier ring 238 (threaded engagement not shown in detail).

When the lock collar 240 is rotated about the first axis A1 in thesecond rotational direction R2, the carrier ring 238 translates alongthe first axis A1 toward the actuator 166 concurrently with the couplingelements 234. Because of the shape of the inner ramp surface 242contacting the coupling elements 234, translation toward the actuator166 urges the coupling elements 234 radially inwardly toward the firstaxis A1 to press against the drive assembly 82 and thereby maintain theorientation of the drive assembly 82 relative to the mount 78.Conversely, when the lock collar 240 is rotated about the first axis A1in the first rotational direction R1, the carrier ring 238 translatesalong the first axis A1 away from the actuator 166 concurrently with thecoupling elements 234, and the coupling elements 234 are then able tomove radially away from the first axis A1 along their respectivecoupling pockets 236. It will be appreciated that other configurationsof the coupling 230 are contemplated. Moreover, the coupling 230 couldbe configured to secure the drive assembly 82 to the rotary instrument80 in any number of different orientations, or in only predefinedorientations (e.g., via a lock or detent mechanism).

It will be appreciated that the coupling 230 effectively creates anadditional joint between the base 34 of the surgical robot 32 and thetool 42. In order to communicate the orientation of the drive assembly82 relative to the mount 78, an orientation sensor arrangement, depictedschematically at 244 in FIG. 4, is interposed between the rotaryinstrument 80 and the drive assembly 82 to determine the orientation ofthe drive assembly 82 relative to the rotary instrument 80. To this end,the orientation sensor arrangement 244 comprises an orientation emitter246 operatively attached to the drive assembly 82, and an orientationdetector 248 operatively attached to the rotary instrument 80 todetermine a position of the orientation emitter 246 relative to therotary instrument 80. Here too, the orientation sensor arrangement 244could be of a number of different types, configurations, and/orarrangements. Alternatively, a selected orientation could be inputtedinto the surgical system 30 manually, such as via the input device 70 ofthe user interface 66 (see FIG. 1).

Referring now to FIGS. 21-24, as noted above, the drive assembly 82 isemployed to translate rotation to the tool 42 attached to the connector86, through the geartrain 84, from either the rotary instrument 80 orthe manual interface 94. To this end, the drive assembly 82 comprises agenerally L-shaped drive body 250 which, as described in greater detailbelow, supports a driver input shaft 252 along the first axis A1 (seeFIG. 23A), and also supports a manual input shaft 254, a retention shaft255, and an intermediate shaft 256 along the second axis A2. The driverinput shaft 252 comprises a driver coupling 258 which is shaped toengage a corresponding actuator coupling 260 (see FIG. 13) coupled tothe actuator 166 for concurrent rotation (e.g., as an interference-type“dog clutch”). The driver input shaft 252, the manual input shaft 254,the retention shaft 255, and the intermediate shaft 256 are eachgenerally supported for rotation relative to the drive body 250 via oneor more bearings 262 (e.g., sealed ball bearings), washers 264, keepers266, and/or spring shims 268 (arrangements generally illustrated inFIGS. 23A-23B and 24, but not described in detail). The drive assembly82 further comprises seals 270 disposed adjacent to the exposed ends ofeach of the driver input shaft 252, the manual input shaft 254, and theretention shaft 255.

In order to translate rotation about the first axis A1 into rotationabout the second axis A2, the geartrain 84 comprises at least one bevelgearset, generally indicated at 272, interposed in rotationalcommunication between the rotary instrument 80 and the connector 86. Thebevel gearset 272 comprises an input gear 274 and an output gear 276.The input gear 274 rotates concurrently with the driver input shaft 252via a key and keyway arrangement, generally indicated at 278. The inputgear 274 is arranged to mesh with the output gear 276 (see FIG. 23A) asdescribed in greater detail below. The output gear 276 rotatesconcurrently with the intermediate shaft 256 via a splined arrangement,generally indicated at 280. Here, the intermediate shaft 256 comprisesouter splines 282 which engage corresponding inner splines 284 of theoutput gear 276 as described in greater detail below.

In the illustrated embodiment, the geartrain 84 of the drive assembly 82comprises at least one reduction gearset, generally indicated at 286,interposed in rotational communication between the rotary instrument 80and the connector 86 such that rotation of the actuator 166 of therotary instrument 80 occurs at a different (e.g., higher or lower) speedthan rotation of the tool 42 attached to the connector 86. Morespecifically, the reduction gearset 286 is interposed in rotationalcommunication between the bevel gearset 272 and the connector 86, and isarranged such that the intermediate shaft 256 (which can be rotated viathe rotary instrument 80 or the manual interface 94) rotates at a higherspeed than the retention shaft 255 (which rotates concurrently with thetool 42 about the second axis A2). While rotation of the actuator 166about the first axis A1 occurs at a higher speed than rotation of thetool 42 about the second axis A2 in the first embodiment of the endeffector 40, other configurations are contemplated and the term“reduction gearset” as used herein may refer to either a reduction inrotational speed (with an increase in torque) or a reduction in torque(with an increase in rotational speed) unless specifically notedotherwise.

Referring now to FIGS. 23A-24, in the illustrated embodiment, thereduction gearset 286 comprises a compound planetary reduction gearsetwith a fixed ring gear 288 formed in the drive body 250 (see FIGS.23A-23B) disposed in meshed engagement with first, second, and thirdsets of planet gears 290A, 290B, 290C each respectively disposed inmeshed engagement with first, second, and third sun gears 292A, 292B,292C. First, second, and third sets of pins 294A, 294B, 294C cooperatewith first, second, and third sets of bushings 296A, 296B, 296C torotatably support the planet gears of the respective sets of planetgears 290A, 290B, 290C for rotation. The sets of pins 294A, 294B, 294Care each fixed to respective first, second, and third carriers 298A,298B, 298C. The first carrier 298A is defined by or otherwiseoperatively attached to the retention shaft 255 and carries the firstset of planet gears 290A, which are also disposed in meshed engagementwith the first sun gear 292A. The first sun gear 292A is coupled to thesecond carrier 298B for concurrent rotation, and the second carrier 298Bcarries the second set of planet gears 290B, which are also disposed inmeshed engagement with the second sun gear 292B. The second sun gear292B is coupled to the third carrier 298C for concurrent rotation, andthe third carrier 298C carries the third set of planet gears 290C, whichare also disposed in meshed engagement with the third sun gear 292C. Thethird sun gear 292C is coupled to the intermediate shaft 256 forconcurrent rotation. Washers 264 may be provided adjacent to one or moreof the carriers 298A, 298B, 298C to help reduce friction with adjacentsets of planet gears 290A, 290B, 290C. Those having ordinary skill inthe art will appreciate that the reduction gearset 286 could be arrangedor configured in a number of different ways, such as with fewer or morethan three planetary reductions, or without any planetary reductions.Other configurations are contemplated.

With continued reference to FIGS. 23A-24, in order to facilitatereleasable attachment to the bit interface 128 of the tool 42, theconnector 86 of the drive assembly 82 generally comprises a connectorbody 300, a flange member 302, a connector biasing element 304, a pairof axial connector elements 306, and a rotational connector element 308.The connector body 300 is operatively attached to the drive body 250(e.g., via threaded engagement) and accommodates bearings 262 whichrotatably support the retention shaft 255 about the second axis A2. Theretention shaft 255 comprises connector element pockets 310 which eachaccommodate one of the axial connector elements 306 to engage againstthe axial retainer 130 of the bit interface 128 of the tool 42 toinhibit relative axial movement between the tool 42 and the retentionshaft 255.

In order to release the tool 42, the flange member 302 is arranged fortranslation along the second axis A2 and can slide along the connectorbody 300 in response to force applied by the surgeon. The flange member302 comprises an axial ramp surface 312 which contacts the axialconnector elements 306. The connector biasing element 304 is interposedbetween the connector body 300 and the flange member 302 so as to urgethe flange member 302 axially away from the connector body 300. Theflange member 302 is prevented from disengaging from the connector bodyvia a stepped surface 314 of the seal 270 coupled to the retention shaft255. Because of the engagement between the axial connector elements 306and the axial ramp surface 312 of the flange member 302, the biasingafforded by the connector biasing element 304 urges the axial connectorelements 306 radially inwardly toward the second axis A2 and intoengagement with the axial retainer 130 of the bit interface 128 of thetool 42, which effects axial retention of the tool 42 relative to thedrive assembly 82. In the illustrated embodiment, the rotationalconnector element 308 of the connector 86 is formed at the distal end ofthe retention shaft 255 and is shaped to abut the rotational retainer132 of the bit interface 128 of the tool 42, which effects concurrentrotation of the tool 42 and the retention shaft 255. Otherconfigurations of the connector 86 are contemplated.

With continued reference to FIGS. 23A-24, the drive assembly 82comprises a clutch mechanism, generally indicated at 316, interposedbetween the manual interface 94 and the geartrain 84. The clutchmechanism 316 is operable between a first mode 316A (see FIG. 23A) and asecond mode 316B (see FIG. 23B). In the first mode 316A, rotationaltorque generated by the actuator 166 of the rotary instrument 80translates through the geartrain 84 to rotate the tool 42 about thesecond axis A2 without rotating the manual interface 94. In the secondmode 316B, force applied to the manual interface 94 is translated astorque through the geartrain 84 to rotate the tool 42 about the secondaxis S2. As is described in greater detail below, the clutch mechanism316 moves from the first mode 316A to the second mode 316B in responseto force applied to the manual interface 94, and comprises a clutchbiasing element 318 arranged to urge the clutch mechanism from thesecond mode 316B toward the first mode 316A.

As is best depicted in FIGS. 23A-23B, the clutch biasing element 318 issupported in a clutch pocket 320 formed in the intermediate shaft 256adjacent to the outer splines 282. The clutch biasing element 318 isalso disposed in engagement with the output gear 276 of the bevelgearset 272 of the geartrain 84. Because the output gear 276 employs theinner splines 284 to engage the outer splines 282 of the intermediateshaft 256 and is not axially fixed to the intermediate shaft 256, theclutch biasing element 318 urges the output gear 276 along the secondaxis A2 into meshed engagement with the input gear 274 to facilitateoperating the clutch mechanism 316 in the first mode 316A (see FIG.23A).

In order to facilitate alignment with the second axis A2, the proximalend of the intermediate shaft 256 comprises a pilot shaft region 322adjacent to the outer splines 282 which is slidably received within acorrespondingly-shaped pilot bore 324 formed in the manual input shaft254 of the manual interface 94 (see FIGS. 23A-23B). The manual inputshaft 254 also comprises an idle bore 326 at its distal end, and linkingspline arrangement 328 is arranged axially between the idle bore 326 andthe pilot bore 324. The outer surface of the manual input shaft 254 isrotatably supported by a bearing 262 which, in turn, is accommodated ina seat 330 attached to the drive body 250. The manual input shaft 254extends through an upper cover 332 also attached to the drive body 250such that the proximal end of the manual input shaft 254 can be engagedby the handle assembly 96, as described in greater detail below.

When the clutch mechanism 316 is in the first mode 316A (see FIG. 23A),the idle bore 326 of the manual input shaft 254 contacts but does notrotate with the outer splines 282 of the intermediate shaft 256.Moreover, because of how the idle bore 326 and the linking splinearrangement 328 are positioned, rotation of the intermediate shaft 256is not translated to the manual input shaft 254 when the clutchmechanism 316 is in the first mode 316A, and the gears 274, 276 of thebevel gearset 272 remain meshed so that rotation of the driver inputshaft 252 translates to the intermediate shaft 256. However, when forceis applied axially to the manual interface 94, the manual input shaft254 translates concurrently with the output gear 276 along the secondaxis A2 toward the connector 86. As shown in FIG. 23B, this causes theoutput gear 276 to come out of meshed engagement with the input gear274, thereby interrupting rotation between the axes A1, A2, and alsobrings the linking spline arrangement 328 of the manual input shaft 254into engagement with the outer splines 282 of the intermediate shaft256, thereby facilitating concurrent rotation of the manual input shaft254 and the intermediate shaft 256.

Thus, axial force applied to the manual interface 94 moves the clutchmechanism 316 from the first mode 316A (see FIG. 23A) to the second mode316B (see FIG. 23B). This configuration effectively prevents thetranslation of rotational torque between the rotary instrument 80 andthe manual interface 94. Put differently, driving the rotary instrument80 will not rotate the manual interface 94 when the clutch mechanism 316is in the first mode 316A, and applying force to rotate the manualinterface 94 will not back-drive the rotary instrument 80. Otherconfigurations of the clutch mechanism 316 are contemplated beyond thoseillustrated in connection with the first embodiment of the end effector40 and described herein.

As is depicted in FIGS. 23A-23B, the illustrated embodiment of the driveassembly 82 and manual interface 94 cooperate to define a guide bore,generally indicated at 334, extending along the second axis A2 from themanual interface 94 and through the various components of the driveassembly 82 to the connector 86. Here, like the cannulated anchor 50 androtary driving tool 48, the guide wire GW (e.g., a “K-Wire”) can extendthrough the guide bore 334 (not shown in detail, but generally known inthe related art).

Referring now to FIGS. 11B-11C, as noted above, the handle assembly 96is employed to attach to the manual interface 94 to, among other things,manually rotate the tool 42 about the second axis A2 and translate themanual input shaft 254 along the second axis A2 in response to forceapplied by the surgeon to the handle assembly 96. To this end, themanual interface 94 comprises a head 336 arranged for rotation about thesecond axis A2, and the handle assembly 96 generally comprises a driver338 and a handle body 340. The head 336 is arranged at the proximal endof the manual input shaft 254, and the driver 338 is shaped to receivethe head 336 for concurrent rotation about the second axis A2 inresponse to force applied to the handle body 340 by the surgeon. As isdepicted schematically in FIGS. 11B-11C, the handle assembly 96 maycomprise a ratcheting mechanism 342 interposed between the handle body340 and the driver 338 to permit concurrent rotation of the handle body340 and the driver 338 about the second axis A2 in a third rotationaldirection R3, and to interrupt rotation of the driver 338 relative tothe handle body 340 about the second axis A2 in a fourth rotationaldirection R4 opposite to the third rotational direction R3. It will beappreciated that the ratcheting mechanism 342 may be of a number ofdifferent types and configurations (e.g., with a ratchet and pawlarrangement, with one or more resiliently flexible members, and thelike). Furthermore, while the handle assembly 96 is releasablyattachable to the manual interface 94 in the illustrated embodiments, itis conceivable that the handle assembly 96 could be permanently affixedto the manual interface 94 (e.g., with a foldable or otherwisearticulable handle body 340).

The present disclosure is also directed toward a method of forming thepilot hole 46 at the surgical site ST along the trajectory T maintainedby the surgical robot 32. The method comprises different steps,including attaching the end effector 40 to the surgical robot 32, withthe end effector 40 supporting the rotary instrument 80, the driveassembly 82, the manual interface 94, and the trigger assembly 88. Themethod also comprises attaching the rotary cutting tool 44 to the driveassembly 82 along the second axis A2, aligning the second axis A2 withthe trajectory T to position the rotary cutting tool 44 at the surgicalsite, and engaging the trigger assembly 88 to generate rotational torquewith the rotary instrument 80 about the first axis A1 and to translatetorque from the rotary instrument 80 about the first axis A1 through thedrive assembly 82 to rotate the rotary cutting tool 44 about the secondaxis A2. The method further comprises advancing the rotary cutting tool44 along the trajectory T at the surgical site ST to the first depth D1,and interrupting rotation about the first axis A1. The method alsocomprises positioning the trigger assembly 88 to present or otherwisepromote access to the manual interface 94, applying force to the manualinterface 94 to rotate the rotary cutting tool 44 about the second axisA2, and advancing the rotary cutting tool 44 along the trajectory T atthe surgical site ST to a second depth D2 greater than the first depthD1.

The present disclosure is also directed toward a method of installingthe anchor 50 at the surgical site ST along the trajectory T maintainedby the surgical robot 32. The method comprises different steps,including attaching the end effector 40 to the surgical robot 32, withthe end effector 40 supporting the rotary instrument 80, the driveassembly 82, the manual interface 94, and the trigger assembly 88. Themethod also comprises attaching the tool 42 to the drive assembly 82along the second axis A2, attaching the anchor 50 to the tool 42, andaligning the second axis A2 with the trajectory to position the anchor50 adjacent to the surgical site ST. The method further includesengaging the trigger assembly 88 to generate rotational torque with therotary instrument 80 about the first axis A1 and to translate torquefrom the rotary instrument 80 about the first axis A1 through the driveassembly 82 to rotate the tool 42 and the anchor 50 about the secondaxis A2. The method also includes advancing the tool 42 and the anchor50 along the trajectory at the surgical site ST to the first depth D1,interrupting rotation about the first axis A1, and positioning thetrigger assembly 88 to present or otherwise promote access to the manualinterface 94. The method further comprises applying force to the manualinterface 94 to rotate the tool 42 and the anchor 50 about the secondaxis A2, and advancing the anchor 50 along the trajectory at thesurgical site ST to the second depth D2 greater than the first depth D1.

The present disclosure is also directed toward a method of installingfirst and second anchors 50 at the surgical site ST along respectivefirst and second trajectories T1, T2 maintained by the surgical robot32. The method comprises different steps, including attaching the endeffector 40 to the surgical robot 32, with the end effector 40supporting the rotary instrument 80, the drive assembly 82, the manualinterface 94, and the trigger assembly 88. The method also comprisesattaching the tool 42 to the drive assembly 82 along the second axis A2,attaching the first anchor 50 to the tool 42, aligning the second axisA2 with the first trajectory to position the first anchor 50 adjacent tothe surgical site ST, and engaging the trigger assembly 88 to generaterotational torque with the rotary instrument 80 about the first axis A1and to translate torque from the rotary instrument 80 about the firstaxis A1 through the drive assembly 82 to rotate the tool 42 and thefirst anchor 50 about the second axis A2. The method further comprisesadvancing the tool 42 and the first anchor 50 along the first trajectoryat the surgical site ST to the first depth D1, interrupting rotationabout the first axis A1, and positioning the trigger assembly 88 topresent or otherwise promote access to the manual interface 94. Themethod also comprises applying force to the manual interface 94 torotate the tool 42 and the first anchor 50 about the second axis A2,advancing the tool 42 and the first anchor 50 along the first trajectoryat the surgical site ST to the second depth D2 greater than the firstdepth D1, and releasing the first anchor 50 from the tool 42. The methodfurther comprises attaching the second anchor 50 to the tool 42,aligning the second axis A2 with the second trajectory to position thesecond anchor 50 adjacent to the surgical site ST, and engaging thetrigger assembly 88 to generate rotational torque with the rotaryinstrument 80 about the first axis A1. The method also comprisestranslating torque from the rotary instrument 80 about the first axis A1through the drive assembly 82 to rotate the tool 42 and the secondanchor 50 about the second axis A2, advancing the tool 42 and the secondanchor 50 along the second trajectory at the surgical site ST to thethird depth D3, interrupting rotation about the first axis A1, andpositioning the trigger assembly 88 to present or otherwise promoteaccess to the manual interface 94. The method further comprises applyingforce to the manual interface 94 to rotate the tool 42 and the secondanchor 50 about the second axis A2, and advancing the tool 42 and thesecond anchor 50 along the second trajectory at the surgical site ST tothe fourth depth D4 greater than the third depth D3.

As noted above, a second embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 25A-28. In the description that follows, thestructure and components of the second embodiment that are the same asor that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 2000. Because many of the components andfeatures of the second embodiment of the end effector 2040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the secondembodiment of the end effector 2040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings. Thus, unless otherwise indicated below, thedescription of the first embodiment of the end effector 40 may beincorporated by reference with respect to the second embodiment of theend effector 2040 without limitation.

Referring now to FIGS. 25A-28, the second embodiment of the end effector2040 is generally shown comprising the mount 2078, the rotary instrument2080 and its actuator 2166 (depicted schematically), and the driveassembly 2082. When compared with the first embodiment described above,the second embodiment of the end effector 2040 generally employs adifferently-configured rotary instrument 2080, drive assembly 2082, andtrigger assembly 2088, each of which will be described in greater detailbelow.

As is best shown in FIGS. 25A-26, in the second embodiment, the rotaryinstrument 2080 and the drive assembly 2082 are configured such that thesecond axis A2 is fixed relative to the first axis A1. Put differently,in this embodiment, the drive body 2250 of the drive assembly 2082 isnot arranged for movement relative to the rotary instrument 2080. Here,the coupling 2230 is operatively attached to the drive assembly 2082 toreleasably secure a drive subassembly, generally indicated at 2344,along the second axis A2. As is best shown in FIG. 28, the drivesubassembly 2344 comprises the reduction gearset 2286, which similarlyhas a planetary configuration and is interposed between the connector2086 and a drive subassembly coupler 2346 that is coupled to the thirdsun gear 2292C. When the drive subassembly 2344 is operatively attachedto the coupling 2230, the drive subassembly coupler 2346 engages anintermediate output coupler 2348 coupled to the intermediate shaft 2256of the drive assembly 2082 which, in this embodiment, also serves as themanual input shaft 2254. While not shown in the drawings of the secondembodiment of the end effector 2040, it will be appreciated that theconnector 2086 of the drive subassembly 2344 can releasably securedifferent types of tools in the same way as the connector 86 describedabove in connection with the first embodiment of the end effector 40.

Here in the second embodiment, the intermediate shaft 2256 of the driveassembly 2082 defines the head 2336 of the manual interface 2094 and iscoupled to the output gear 2276 of the bevel gearset 2272 of thegeartrain 2084. The head 2336 of the manual interface 2094 is likewisearranged to receive and translate applied force from the user intorotational torque used to rotate tools (not shown in FIGS. 25A-28) aboutthe second axis A2. As is described in greater detail below, the triggerassembly 2088 of the second embodiment of the end effector 2040 is notconfigured so as to limit access to the manual interface 2094 in any ofthe trigger assembly positions P1, P2. Rather, in this embodiment, theend effector 2040 further comprises a guard cover, generally indicatedat 2350, which is operatively attached to the drive assembly 2082 and isarranged for movement relative to the second axis A2 between a firstguard position U1 (see FIG. 25A) and a second guard position U2 (seeFIG. 25B).

In the first guard position U1, the second axis A2 intersects at least aportion of the guard cover 2350 to limit access to the manual interface2094 (see FIG. 25A). In the second guard position U2, the guard cover2350 is spaced from the second axis A2 to promote access to the manualinterface 2094 (see FIG. 25B). To this end, and as is best shown inFIGS. 25A-25B and 28, the guard cover 2350 comprises a guard body 2352that defines a guard pocket 2354 shaped to accommodate or otherwiseinhibit access to at least a portion of the manual interface 2094 in thefirst guard position U1. The guard body 2352 is provided with a guardhinge 2356 that is operatively attached to the drive assembly 2082 forpivoting movement about a guard axis UA between the first guard positionU1 (see FIG. 25A) and the second guard position U2 (see FIG. 25B). Inthe illustrated embodiment, the guard axis UA is arranged substantiallyperpendicular to both the first axis A1 and the second axis A2.

It will be appreciated that utilization of the guard cover 2350 allowsthe end effector 2040 to limit or otherwise inhibit access to the manualinterface 2094 without necessarily relying on movement of the triggerassembly 2088. Thus, in the second embodiment, while the triggerassembly 2088 is nevertheless arranged for movement with the retainer2136 between the first trigger assembly position P1 (see FIG. 25A) andthe second trigger assembly position P2 (see FIG. 25B), no portion ofthe trigger assembly 2088 limits or otherwise inhibits access to themanual interface 2094 in either of the trigger assembly positions P1,P2.

The grip 2090 of the trigger assembly 2088 has a generally cylindricalprofile and is configured for generally neutral hand engagement when inthe first trigger assembly position P1 (see FIG. 25A), and for generallypronate or supernate hand engagement when in the second trigger assemblyposition P2 (see FIG. 25B). Here too in this embodiment, the triggerassembly 2088 is arranged for concurrent movement with the retainer 2136such that the input trigger 2092 can be moved between the first inputposition I1 (see FIG. 27A) and the second input position I2 (see FIG.27B) irrespective of whether the trigger assembly 2088 is arranged inthe first trigger assembly position P1 (see FIG. 25A) or the secondtrigger assembly position P2 (see FIG. 25B).

Referring now to FIGS. 26-27B, the trigger assembly 2088 in thisembodiment is similarly configured such that movement of the inputtrigger 2092 effects corresponding movement of the piston 2182 (seeFIGS. 27A-28B) which, in turn, engages and moves the fork guide 2188 ofthe retainer 2136 (see FIG. 26). As shown in FIGS. 27A-27B, the linkage2178 in this embodiment comprises a slide member 2358 supported withinthe grip 2090 for concurrent movement with the input trigger 2092between the first and second input positions I1, I2. Here, the slidemember 2358 defines two slide ramps 2360 which engage against respectivebearings 2262 supported on the piston 2182 and on the extension member2194 of the input trigger 2092 to effect translation of motion from theinput trigger 2092 to the piston 2182 (compare FIGS. 27A-27B). While notshown, it will be appreciated that the linkage 2178 may compriseadditional components (e.g., biasing elements, bushings, fasteners,seals, and the like). Other configurations are contemplated.

As noted above, a third embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 29A-31B. In the description that follows,the structure and components of the third embodiment that are the sameas or that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 3000. Because many of the components andfeatures of the third embodiment of the end effector 3040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the thirdembodiment of the end effector 3040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings. Thus, unless otherwise indicated below, thedescription of the first embodiment of the end effector 40 may beincorporated by reference with respect to the third embodiment of theend effector 3040 without limitation.

Referring now to FIGS. 29A-31B, the third embodiment of the end effector3040 is generally shown comprising the mount 3078, the rotary instrument3080 and its actuator 3166 (depicted schematically), and the driveassembly 3082. When compared with the first embodiment described above,the third embodiment of the end effector 3040 generally employs adifferently-configured trigger assembly 3088 and drive assembly 3082,and is configured to secure tools 3042 with different types of bitinterfaces 3128, each of which will be described in greater detailbelow.

As is best shown in FIGS. 29A-30, in the third embodiment, the driveassembly 3082 is similarly configured for releasable attachment to therotary instrument 3080 via the coupling 3230 such that the second axisA2 can be moved relative to the first axis A1 by positioning the driveassembly 3082 in different ways about the first axis A1. The triggerassembly 3088 in the third embodiment employs a grip 3090 and an inputtrigger 3092 which are similar in construction to the second embodimentof the trigger assembly 2088 described above. However, in the thirdembodiment, the frame 3134 of the trigger assembly 3088 generallycomprises a first frame body 3362 coupled to the retainer 3136 forconcurrent movement between the plurality of trigger assembly positions(first trigger assembly position P1 shown in FIGS. 29A-29B), and asecond frame body 3364 supporting the grip 3090 and the input trigger3092 for movement relative to the first frame body 3362 between aplurality of grip positions, including a first grip position G1 (seeFIG. 29A) and a second grip position G2 (see FIG. 29B).

When in the first grip position G1 as shown in FIG. 29A, at least aportion of the second frame body 3364 limits access to the manualinterface 3094, and the input trigger 3092 is arranged for engagement bythe user to drive the rotary instrument 3080 to rotate whichever tool3042 is secured to the connector 3086 about the second axis A2, asdescribed in greater detail below. However, when in the second gripposition G2 as shown in FIG. 29B, the second frame body 3364 is disposedin spaced relation to the manual interface 3094 to facilitate receivingapplied force from the user to rotate the tool 3042 about the secondaxis A2. While not illustrated in connection with the third embodiment,the second frame body 3364 is also arranged for concurrent movement withthe first frame body 3362 between the plurality of trigger assemblypositions (first trigger assembly position P1 shown in FIGS. 29A-29B)independent of movement between the plurality of grip positions (e.g.,the first and second grip positions G1, G2).

In the third embodiment of the end effector 3040, the second frame body3364 is arranged for translational movement between the first and secondgrip positions G1, G2, the movement being substantially parallel to thefirst axis A1. To this end, the second frame body 3364 comprises a rider3366 which is supported for sliding movement along a track 3368 definedin the first frame body 3362. It will be appreciated that thisconfiguration is exemplary, and that the first and second frame bodies3362, 3364 could be configured in a number of different ways sufficientto permit the second frame body 3364 to move relative to the first framebody 3362 to selectively inhibit access to and/or promote access to themanual interface 3094. By way of illustrative example, movement betweenthe first and second grip positions G1, G2 could be defined by othertypes of translational movement (e.g., sliding along a curved path or ina direction that is non-parallel to the first axis A1), rotationalmovement, or other types of movement. Other configurations arecontemplated.

Referring now to FIGS. 30-31B, as noted above, the third embodiment ofthe end effector 3040 is configured to secure tools 3042 with differenttypes of bit interfaces 3128 via the connector 3086. FIG. 30 depicts tworepresentative tools 3042 realized as the rotary cutting tool 3044(e.g., a drill bit), and the rotary driving tool 3048 (e.g., a polyaxialscrewdriver) supporting an anchor 3050 (e.g., a polyaxial screw). Whilethe bit interface 3128 of the rotary driving tool 3048 is configured inthe same way as the bit interface 128 used with the first embodiment ofthe end effector 40, the bit interface 3128 of the illustrated rotarycutting tool 3044 includes an extension portion 3370 extending away fromthe axial retainer 3130 and the rotational retainer 3132. As isdescribed in greater detail below, the extension portion 3370 of the bitinterface 3128 of the rotary cutting tool 3044 in the third embodimentcooperates with a transmission, generally indicated at 3372, of thedrive assembly 3082 to facilitate operating the geartrain 3084 of thedrive assembly 3082 at different drive ratios.

As is best shown in FIGS. 31A-31B, for the drive assembly 3082 of thethird embodiment of the end effector 3040, the driver input shaft 3252is supported by bearings 3262 seated in an input body 3374 that isoperatively attached to the drive body 3250 (e.g., via fasteners). Heretoo, the input gear 3274 of the bevel gearset 3272 is coupled to thedriver input shaft 3252 and is arranged for rotation about the firstaxis A1. However, the output gear 3276 of the bevel gearset 3272 iscoupled to an idler shaft 3376 in this embodiment. Here, the idler shaft3376 is supported by bearings 3262 seated in the upper cover 3332 and inan intermediate body 3378 arranged between the upper cover 3332 and thedrive body 3250. The idler shaft 3376 rotates about an idler axis IAthat is arranged substantially parallel to and spaced from the secondaxis A2. The intermediate shaft 3256 of the drive assembly 3082 which,in this embodiment, also serves as the manual input shaft 3254, issimilarly supported by bearings 3262 seated in the upper cover 3332 andthe intermediate body 3378, rotates about the second axis A2, and iscoupled to the third sun gear 3292C of the reduction gearset 3286.Pulleys, generally indicated at 3380, are respectively supported on theintermediate shaft 2256 and the idler shaft 3376 and are interconnectedvia an endless belt 3382 such that the intermediate shaft 3256 and theidler shaft 3376 rotate concurrently. While the pulleys 3380 have thesame configuration as each other in the illustrated embodiment, it willbe appreciated that differently-sized pulleys could be utilized in someembodiments, such as to provide an increase in rotational speed ortorque between the intermediate shaft 3256 and the idler shaft 3376.Furthermore, while not depicted herein, it will be appreciated that thedrive assembly 3082 could employ a tensioner to remove slack in theendless belt 3382 in some embodiments. Moreover, in other embodiments,it is contemplated that a chain and sprocket arrangement could be usedin place of the illustrated endless belt 3382 and pulley 3380arrangement. Other configurations are contemplated.

While the drive assembly 3082 of the third embodiment of the endeffector 3040 similarly employs a planetary configuration for thereduction gearset 3286, various components are arranged differently soas to effect operation of the transmission 3372. To this end, ratherthan being disposed in meshed engagement with the ring gear 3288, thefirst, second, and third sets of planet gears 3290A, 3290B, 3290C areeach respectively disposed in meshed engagement with inner teeth 3384 ofa shift collar 3386 of the transmission 3372. As is described in greaterdetail below, the inner teeth 3384 of the shift collar 3386 are alsoarranged to selectively engage shaft teeth 3388 of the intermediateshaft 3256 in splined engagement, and the shift collar 3386 furthercomprises outer teeth 3390 which are arranged selectively engage thering gear 3288 in splined engagement. Moreover, in this embodiment, thering gear 3288 is formed as a discrete component that is supportedwithin the drive body 3250 between a pair of bushings 3196.

With continued reference to FIGS. 31A-31B, the transmission 3372 of thedrive assembly 3082 is generally configured so as to be interposed inrotational communication between the rotary instrument 3080 (see FIGS.29A-30) and the connector 3086, and comprises a first gearset GS1, asecond gearset GS2, and the shift collar 3386. Here, the shift collar3386 is arranged for movement, along the second axis A2, between a firstcollar position CP1 (see FIG. 31A) and a second collar position CP2 (seeFIG. 31B).

In the first collar position CP1, the shift collar 3386 engages thefirst gearset GS1 to translate rotation between the rotary instrument3080 and the connector 3086 at a first drive ratio DR1. In thisembodiment, the first gearset GS1 is defined by splined engagementbetween the ring gear 3288 and the outer teeth 3390 of the shift collar3386 such that the shift collar 3386 is effectively “fixed” to the drivebody 3250 (see FIG. 31A). Thus, in the first collar position CP1,rotation of the intermediate shaft 3256, caused either from torquegenerated via the rotary instrument 3080 or force applied to the head3336 of the manual interface 3094, is translated through the planetaryreduction gearset 3286 to the retention shaft 3255 of the connector3086.

In the second collar position CP2, the shift collar 3386 engages thesecond gearset GS2 to translate rotation between the rotary instrument3080 and the connector 3086 at a second drive ratio DR2 that isdifferent from the first drive ratio DR1. In this embodiment, the secondgearset GS2 is defined by splined engagement between the inner teeth3384 of the shift collar 3386 and the shaft teeth 3388 of theintermediate shaft 3256 such that the shift collar 3386 rotatesconcurrently with the intermediate shaft 3256 about the second axis A2within the drive body 3250 (see FIG. 31B). Thus, in the second collarposition CP2, rotation of the intermediate shaft 3256, caused eitherfrom torque generated via the rotary instrument 3080 or force applied tothe head 3336 of the manual interface 3094, effectively bypasses theplanetary reduction gearset 3286 and is translated directly through theshift collar 3386 to the retention shaft 3255 of the connector 3086. Putdifferently, in the second collar position CP2, the intermediate shaft3256 rotates at the same speed as the connector 3086 (and, thus, thesecured tool 3042).

In the illustrated embodiment, the transmission 3372 comprises atransmission linkage, generally indicated at 3392, that is operativelyattached to the shift collar 3386 for concurrent movement between thefirst and second collar positions CP1, CP2. Here in this embodiment, thetransmission linkage 3392 comprises a selector 3394 that is supportedfor movement by braces 3396 operatively attached to the retention shaft3255 of the connector 3086. The selector 3394 is shaped and arranged forsliding movement along the braces 3396 which, in turn, respectivelysupport the pins of the first set of pins 3294A of the reduction gearset3286 in this embodiment.

As is best shown in FIG. 31B, the selector 3394 is also arranged toengage the extension portion 3370 of the bit interface 3128 of therotary cutting tool 3044 to move the shift collar 3386 to the secondcollar position CP2 when the rotary cutting tool 3044 is secured to theconnector 3086 of the drive assembly 3082. Conversely, and as is shownin FIG. 31A, the selector 3394 is arranged to move the shift collar 3386to the first collar position CP1 when the rotary driving tool 3048 issecured to the connector 3086 of the drive assembly 3082 because noportion of the bit interface 3128 of the rotary driving tool 3048engages the selector 3394, unlike the extension portion 3370 of the bitinterface 3128 of the rotary cutting tool 3044 depicted in FIG. 31B. Inthe illustrated embodiment, the transmission 3372 also comprises alinkage biasing element 3398 (e.g., a compression spring, one or morespring washers, and the like) that is arranged to urge the shift collar3386 toward the first collar position CP1 (see FIG. 31A).

It will be appreciated that the functionality afforded by thetransmission 3372 allows the drive assembly 3082 to drive tools 3042 ateither the first drive ratio DR1 or the second drive ratio DR2 dependingon the presence or absence of the extension portion 3370. As such, tools3042 can be designed with or without the extension portion 3370 based,among other things, on their intended rotational speed range during use.Moreover, this configuration advantageously allows the transmission 3372to “shift” between the gearsets GS1, GS2 “automatically” based on theconfiguration of the secured tool 3042, without requiring additionaluser interaction beyond securing the tool 3042 to the connector 3086(e.g., to shift “manually” or otherwise select a gearset).

While the transmission 3372 affords “automatic” shifting between thegearsets GS1, GS2 to facilitate driving different tools 3042 atdifferent drive ratios DR1, DR2, it will be appreciated that the driveassembly 3082 can be configured to facilitate driving at different driveratios DR1, DR2 without necessarily utilizing the transmission 3372, asis described in greater detail below in connection with otherembodiments. Furthermore, while the transmission 3372 described above isconfigured to facilitate movement of the shift collar 3386 viaengagement between the selector 3394 and the extension portion 3370 ofthe tool 3042, it will be appreciated that the selector 3394 could beconfigured to engage different portions of tools 3042 besides theextension portion 3370 illustrated in FIGS. 30 and 31B. Otherconfigurations are contemplated.

As noted above, a fourth embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 32-34C. In the description that follows, thestructure and components of the fourth embodiment that are the same asor that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 4000. Because many of the components andfeatures of the fourth embodiment of the end effector 4040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the fourthembodiment of the end effector 4040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings.

Thus, unless otherwise indicated below, the description of the firstembodiment of the end effector 40 may be incorporated by reference withrespect to the fourth embodiment of the end effector 4040 withoutlimitation. Likewise, certain components and features of the fourthembodiment of the end effector 4040 that are similar to correspondingcomponents and features of previously-described embodiments may bereferred to or otherwise depicted in the drawings as provided with thesame reference numerals increased by 1000 plus another 1000 for everyintervening embodiment (e.g., for the fourth embodiment, componentsdescribed in connection with the third embodiment would be increased by1000, and components described in connection with the second embodimentwould be increased by 2000).

Referring now to FIGS. 32-34C, the fourth embodiment of the end effector4040 is generally shown comprising the mount 4078, the rotary instrument4080 and its actuator 4166 (depicted schematically), and the driveassembly 4082. When compared with the first embodiment described above,the fourth embodiment of the end effector 4040 generally employs adifferently-configured trigger assembly 4088 and drive assembly 4082,interacts with a differently-configured handle assembly 4096, and isconfigured to secure tools 4042 with different types of bit interfaces4128, each of which will be described in greater detail below.

As is best shown in FIGS. 32-33, in the fourth embodiment, the driveassembly 4082 is similarly configured for releasable attachment to therotary instrument 4080 via the coupling 4230 such that the second axisA2 can be moved relative to the first axis A1 by positioning the driveassembly 4082 in different ways about the first axis A1. The triggerassembly 4088 in the third embodiment employs a grip 4090 with acontoured profile, and an input trigger 4092 which is similar inconstruction to the second embodiment of the trigger assembly 2088described above. As will be appreciated from the subsequent descriptionbelow, the trigger assembly 4088 depicted in FIGS. 32-33 is exemplary inthe fourth embodiment, and the drive assembly 4082 can be utilized witha number of different types of trigger assemblies 4088 which may beconfigured so as to be movable to limit and/or promote access to themanual interface 4094 (movement not shown in the fourth embodiment).

With continued reference to FIGS. 32-33, the handle assembly 4096 in thefourth embodiment has a different configuration than the handle assembly96 described in connection with the first embodiment. Specifically, thehandle assembly 4096 has a more symmetric profile and is generallyconfigured to selectively lock, both rotatably and axially, to the head4336 of the manual interface 4094 (locking not shown). In thisembodiment, the drive assembly 4082 further comprises a differentialassembly 4400 interposed between the rotary instrument 4080, theconnector 4086, and the manual interface 4094. As is described ingreater detail below, the differential assembly 4400 is operable in ahaptic torque mode 4400H (see FIG. 34A; not shown in detail) where thehandle assembly 4096 can be engaged by the user while driving the tool4042 via the rotary instrument 4080 as a way to provide the user withtactile torque feedback. When not being utilized (e.g., as the endeffector 4040 is being repositioned), the handle assembly 4096 can bestowed in a dock 4402 formed on the drive body 4250 of the driveassembly 4082 (see FIG. 32).

In addition to allowing the user to sense tactile torque feedbackthrough the handle assembly 4096 at the manual interface 4094 in thehaptic torque mode 4400H, the differential assembly 4400 also affordsfunctionality that is similar to the clutch mechanism 316 describedabove in connection with the first embodiment of the end effector 40.Specifically, the differential assembly 4400 is also operable between afirst interrupt mode 4400A (see FIG. 34B; not shown in detail) and asecond interrupt mode 4400B (see FIG. 34C; not shown in detail). In thefirst interrupt mode 4400A, rotational torque generated by the rotaryinstrument 4080 translates through the differential assembly 4400 to theconnector 4086 to rotate the tool 4042 about the second axis A2 withouttranslating rotational torque to the head 4336 of the manual interface4094. In the second interrupt mode 4400B, rotational torque generated asforce is applied to the head 4336 of the manual interface 4094translates through the differential assembly 4400 to the connector 4086to rotate the tool 4042 without translating rotational torque to therotary instrument 4080.

Operation of the differential assembly 4400 in the first interrupt mode4400A is achieved by selectively locking the manual input shaft 4254 tothe upper cover 4332 of the drive assembly 4082 via a first pin 4404(see FIG. 34B; not shown in detail). Similarly, operation of thedifferential assembly 4400 in the second interrupt mode 4400B isachieved by selectively locking the differential assembly 4400 to theupper cover 4332 of the drive assembly 4082 via a second pin 4406 (seeFIG. 34C; not shown in detail). Furthermore, operation of thedifferential assembly 4400 in the haptic torque mode 4400H is achievedby selectively removing the first and second pins 4404, 4406 from theupper cover 4332 of the drive assembly 4082 (see FIG. 34A; not shown indetail) and connecting the handle assembly 4096 to the head 4336 of themanual interface 4094 to prevent rotation of the head 4336 about thesecond axis A2 as the rotary instrument 4080 is driven to rotate thetool 4042 about the second axis A2.

Referring now to FIGS. 34A-34C, the differential assembly 4400 of thedrive assembly 4082 generally comprises an interface-side gear 4408disposed in rotational communication with the manual interface 4094, aconnector-side gear 4410 disposed in rotational communication with theconnector 4086, a differential case 4412 disposed in rotationalcommunication with the rotary instrument 4080, a pinion shaft 4414operatively attached to the differential case 4412 for concurrentmovement, and a pair of pinion gears 4416 each supported by the pinionshaft 4414 and disposed in meshed engagement with the interface-sidegear 4408 and the connector-side gear 4410. A differential housing 4418operatively attached to the drive assembly 4082 defines a differentialchamber 4420 shaped to accommodate at least a portion of thedifferential case 4412 of the differential assembly 4400 therein. Eachof the components of the differential assembly 4400 introduced abovewill be described in greater detail below.

Here too in the fourth embodiment of the end effector 4040, thegeartrain 4084 of the drive assembly 4082 similarly employs a planetaryreduction gearset 4286 and the bevel gearset 4272. However, in thisembodiment, the reduction gearset 4286 is interposed in rotationalcommunication between the rotary instrument 4080 (see FIGS. 32-33) andthe bevel gearset 4272. More specifically, the components of theplanetary reduction gearset 4286 are supported in the input body 4374and are generally arranged about the first axis A1 between the driverinput shaft 4252 and a carrier shaft 4422. Here, the input gear 4274 ofthe bevel gearset 4272 is coupled to the carrier shaft 4422 forconcurrent rotation about the first axis A1, and the output gear 4276 ofthe bevel gearset 4272 is coupled to the differential case 4412 forconcurrent rotation about the second axis A2.

The differential case 4412 is rotatably supported by bearings 4262disposed in the drive body 4250, the differential housing 4418, and theupper cover 4332, and has an annular hub 4424 supported by ribs (notshown in detail) that is provided with a plurality of hub apertures 4426shaped to receive the second pin 4406 when aligned with a radial coveraperture 4428 formed in the upper cover 4332 so as to facilitateoperation in the second interrupt mode 4400B. The manual input shaft4254 is similarly supported by bearings 4262 disposed in the upper cover4332 and the differential case 4412, is coupled to the interface-sidegear 4408, and is provided with an interface aperture 4430 shaped toreceive the first pin 4404 when aligned with a transverse cover aperture4432 formed in the upper cover 4332 so as to facilitate operation in thefirst interrupt mode 4400A. The pinion shaft 4414 is carried by thedifferential case 4412 and rotatably supports the pinion gears 4416,which are disposed in meshed engagement with the interface-side gear4408 and the connector-side gear 4410, as noted above. Here, theconnector-side gear 4410 is coupled to the intermediate shaft 4256which, in this embodiment, is rotatably supported by bearings 4262disposed in the differential case 4412.

The differential housing 4418 of the differential assembly 4400 definesa differential axis DA which, in the illustrated embodiment, iscoincident with the second axis A2. Here, rotation of the differentialcase 4412 is permitted relative to the differential housing 4418 when inthe first interrupt mode 4400A. Conversely, rotation of the differentialcase 4412 is inhibited relative to the differential housing 4418 when inthe second interrupt mode 4400B. Furthermore, rotation of both theinterface-side gear 4408 and the connector-side gear 4410 is permittedabout the differential axis DA when in the second interrupt mode 4400B.However, when in the first interrupt mode 4400A, rotation of theconnector-side gear 4410 about the differential axis DA is permitted,but rotation of the interface-side gear 4408 about the differential axisDA is inhibited. Moreover, the pinion shaft 4414 defines a pinion axisPA about which the pinion gears 4416 are permitted to rotate in thefirst interrupt mode 4400A, the second interrupt mode 4400B, and thehaptic torque mode 4400H. In the illustrated embodiment, the pinion axisPA is substantially perpendicular to the differential axis DA.

As noted above, when operating in the haptic torque mode 4400H with thehandle assembly 4096 connected to the head 4336 of the manual interface4094, the user can grasp the handle assembly 4096 to prevent rotation ofthe head 4336 about the second axis A2 as the rotary instrument 4080 isdriven to rotate the tool 4042 about the second axis A2. When driven bythe actuator 4166, the manual input shaft 4254 and the intermediateshaft 4256 each experience the same amount of torque but can rotate atdifferent speeds.

Thus, because the differential assembly 4400 is interposed between therotary instrument 4080 and the tool 4042 as a part of the geartrain4084, if the user prevents the manual input shaft 4254 from rotatingabout the second axis A2 by grasping the handle assembly 4096, haptic(or “tactile”) torque feedback is translated to the user's hand. Eventhough the handle assembly 4096 does not rotate when grasped, the userwill nevertheless experience torque feedback that is substantiallyequivalent to the amount of torque being applied to the tool 4042. Thus,if the driven tool 4042 comprises the rotary driving tool 4048 with theanchor 4050, the user would “feel” torque in the handle assembly 4096that is equivalent to torque in the anchor 4050. This torque feedbackadvantageously provides the user with a relative sense of the resistanceto rotation being experienced by the anchor 4050 while using the rotaryinstrument 4080 to drive the anchor 4050.

With continued reference to FIGS. 34A-34C, in the fourth embodiment ofthe end effector 4040, the geartrain 4084 further comprises an auxiliarygearset, generally indicated at 4434, which is interposed between theintermediate shaft 4256 and the connector 4086. The auxiliary gearset4434 is disposed within an auxiliary housing 4436 secured to the drivebody 4250 with fasteners, with an auxiliary ring gear 4438 arrangedtherebetween. A total of four auxiliary planet gears 4440 are disposedin meshed engagement with the auxiliary ring gear 4438 and also with anauxiliary sun gear 4442. The auxiliary planet gears 4440 are secured viafasteners to an auxiliary carrier 4444 and to a first interface body4446 which, in turn, are supported by bearings 4262 respectivelydisposed in the drive body 4250 and the auxiliary housing 4436.

The first interface body 4446 comprises a cross recess 4448 whichdefines a rotational lock that is shaped to engage the bit interface4128 of the rotary driving tool 4048 illustrated in FIG. 33, asdescribed in greater detail below. A second interface body 4450 iscoupled to the auxiliary sun gear 4442 and is supported by bearings 4262disposed in the auxiliary carrier 4444 and the first interface body4446. A peg 4452 is operatively attached to the second interface body4450 and defines another rotational lock that is shaped to engage thebit interface 4128 of the rotary cutting tool 4044 illustrated in FIG.33, as described in greater detail below.

In the representative embodiment illustrated herein, the peg 4452defines a first rotational lock RL1 (see FIG. 34B), and the cross recess4448 defines a second rotational lock RL2. Here, the peg 4452 of thefirst rotational lock RL1 is arranged closer to the manual interface4094 than the cross recess 4448 of the second rotational lock RL2. Thisarrangement corresponds to the configurations of the bit interfaces 4128of the rotary driving tool 4048 and the rotary cutting tool 4044illustrated in FIG. 33. The bit interfaces 4128 shown in FIG. 33 eachemploy axial retainers 4130 that are similar to those previouslydescribed in connection with the bit interface 128 utilized with thefirst embodiment of the end effector 40. However, in the fourthembodiment, the rotational retainers 4132 are different, both from eachother and from the first embodiment. More specifically, in the fourthembodiment, the bit interface 4128 of the rotary cutting tool 4044comprises a notch element 4454 that is shaped to engage the firstrotational lock RL1 (see FIG. 34B), and the bit interface 4128 of therotary driving tool 4048 comprises a key element 4456 that is configuredto engage the second rotational lock RL2 (see FIG. 34C). The key element4456 has a rounded, generally rectangular profile that is shaped toengage in the cross recess 4448 such that the rotary driving tool 4048rotates concurrently about the second axis A2 with the first interfacebody 4446 of the auxiliary gearset 4434 when secured to the connector4086 (see FIG. 34C). The notch element 4454 is provided with a profilethat is configured so as to pass through the cross recess 4448 beforeengaging on opposing sides of the peg 4452 such that the rotary cuttingtool 4044 rotates concurrently about the second axis A2 with the secondinterface body 4450 when secured to the connector 4086 (see FIG. 34B).

While the drive assembly 4082 comprises the first rotational lock RL1and the second rotational lock RL2 in the fourth embodiment, it will beappreciated that other embodiments described herein may employ only thefirst rotational lock RL1. Furthermore, rotational locks could be of anumber of different configurations including, for example, similar tothe rotational connector element 308 formed in the retention shaft 255of the connector 86 of the drive assembly 82 described above inconnection with the first embodiment of the end effector 40. Otherconfigurations are contemplated

Here in the fourth embodiment, axial retention of tools 4042 secured tothe connector 4086 is achieved with an axial lock AL configured toreleasably secure one of the rotary cutting tool 4044, the rotarydriving tool 4048, or another tool 4042 for concurrent translation withthe drive assembly 4082 along the trajectory T maintained by thesurgical robot 32 (see FIG. 1). To this end, the axial lock AL isoperable between a release configuration ACR (see FIG. 34A) and a lockconfiguration ACL (see FIGS. 34B-34C). When the axial lock AL operatesin the release configuration ACR shown in FIG. 34A, relative movementbetween the drive assembly 4082 and the tool 4042 secured to either ofthe first and second rotational locks RL1, RL2 (tools 4042 not shown inFIG. 34A) is permitted along the second axis A2. When the axial lock ALoperates in the lock configuration ACL as shown in FIGS. 34B-34C,relative movement between the drive assembly 4082 and the tool 4042secured to either the first rotational lock RL1 (see FIG. 34B) or thesecond rotational lock RL2 (see FIG. 34C) is restricted along the secondaxis A2.

The axial lock AL is realized in the fourth embodiment by generallyspherical axial connector elements 4306 which form part of the connector4086 and operate in substantially the same way as the first embodimentof the end effector 40. Here, however, the retention shaft 4255 of theconnector 4086 is supported by bearings 4262 disposed in the connectorbody 4300 and also disposed in a rider body 4458 that moves concurrentlywith the flange member 4302. When in the lock configuration ACL, theaxial connector elements 4306 are supported by the bearing 4262 and alsoengage the axial retainer 4130 of the bit interfaces 4128 of the rotarycutting tool 4044 and the rotary driving tool 4048 to restrict relativemovement therebetween along the second axis A2. When the flange member4302 of the connector 4086 is engaged by the user to move to the releaseconfiguration ACR, movement of the flange member 4302 along the secondaxis A2 brings the axial connector elements 4306 out of engagement withthe axial retainer 4130 and out of support with the bearing 4262. Thisarrangement permits concurrent rotation of the retention shaft 4255 andthe bit interface 4128 of the tool 4042 when secured to the axial lockAL in the lock configuration ACL, and allows the retention shaft 4255 torotate independent of the first and second rotational locks RL1, RL2when tools 4042 are removed from the connector 4086.

Here too, it will be appreciated that axial locks could be of a numberof different configurations including, for example, similar to the axialconnector elements 306 disposed in the connector element pockets 310formed in the retention shaft 255 of the connector 86 of the driveassembly 82 described above in connection with the first embodiment ofthe end effector 40. Other configurations are contemplated.

In the fourth embodiment of the end effector 4040, the auxiliary gearset4434 effectively acts as a speed increaser between the intermediateshaft 4256 and the second interface body 4450 such that the peg 4452 ofthe first rotational lock RL1 is driven at the first drive ratio DR1,while the cross recess 4448 of the second rotational lock RL2 is drivenat the second drive ratio DR2 and rotates concurrently with theintermediate shaft 4256. Here, rotation of the intermediate shaft 4256is translated through an intermediate coupler 4460 to the auxiliarycarrier 4444. Rotation of the auxiliary carrier 4444 causes theauxiliary planet gears 4440 to orbit the second axis A2 and rotate abouttheir own axes while remaining in meshed engagement with the auxiliaryring gear 4438 and the auxiliary sun gear 4442 such that the auxiliarysun gear 4442 rotates about the second axis A2 faster than the auxiliarycarrier 4444. Thus, as noted above, different tools 4042 can be drivenby the drive assembly 4082 at different, predetermined drive ratioswithout necessarily requiring a transmission to “shift” betweendifferent gearsets.

As noted above, a fifth embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 35-38B. In the description that follows, thestructure and components of the fifth embodiment that are the same as orthat otherwise correspond to the structure and components of the firstembodiment of the end effector 40 are provided with the same referencenumerals increased by 5000. Because many of the components and featuresof the fifth embodiment of the end effector 5040 are substantiallysimilar to those of the first embodiment of the end effector 40described above, for the purposes of clarity, consistency, and brevity,only certain specific differences between the fifth embodiment of theend effector 5040 and the first embodiment of the end effector 40 willbe described below, and only some of the components and features commonbetween the embodiments will be discussed herein and depicted in thedrawings.

Thus, unless otherwise indicated below, the description of the firstembodiment of the end effector 40 may be incorporated by reference withrespect to the fifth embodiment of the end effector 5040 withoutlimitation. Likewise, certain components and features of the fifthembodiment of the end effector 5040 that are similar to correspondingcomponents and features of previously-described embodiments may bereferred to or otherwise depicted in the drawings as provided with thesame reference numerals increased by 1000 plus another 1000 for everyintervening embodiment (e.g., for the fifth embodiment, componentsdescribed in connection with the fourth embodiment would be increased by1000, components described in connection with the third embodiment wouldbe increased by 2000, and components described in connection with thesecond embodiment would be increased by 3000).

Referring now to FIGS. 35-38B, the fifth embodiment of the end effector5040 is generally shown comprising the mount 5078, the rotary instrument5080 and its actuator 5166 (depicted schematically), and the driveassembly 5082. When compared with the first embodiment described above,the fifth embodiment of the end effector 5040 generally employs adifferently-configured trigger assembly 5088 and drive assembly 5082,and is configured to secure tools 5042 in a “top loading” manner througha drive conduit 5462 which forms part of the geartrain 5084. Each ofthese components will be described in greater detail below.

As is best shown in FIGS. 35-36, the fifth embodiment of the endeffector 5040 is provided with the same trigger assembly 5088, grip5090, and input trigger 5092 as described above in connection with thesecond embodiment of the end effector 2040. Also like the secondembodiment described above, in the fifth embodiment of the end effector5040, the rotary instrument 5080, and the drive assembly 5082 areconfigured such that the second axis A2 is fixed relative to the firstaxis A1. Put differently, here too in this embodiment, the drive body5250 of the drive assembly 5082 is not arranged for movement relative tothe rotary instrument 5080. However, as will be appreciated from thesubsequent description below, the drive assembly 5082 and/or the rotaryinstrument 5080 could be configured differently, such as to permitrelative positioning about the first axis A1 in ways similar to thefirst embodiment of the end effector 40. Other configurations arecontemplated.

Because the drive assembly 5082 of the fifth embodiment of the endeffector 5040 is provided with the drive conduit 5462 to facilitate “toploading” of different types of tools 5042, as noted above and as isdescribed in greater detail below, the manual interface 5094 of thefifth embodiment is realized by the bit interface 5128 of whichever tool5042 is secured to the drive assembly 5082 rather than as a portion ofthe drive assembly 5082 itself. However, this configuration isexemplary, and as will be appreciated from the subsequent descriptionbelow, the end effector 5040 could be provided with a separate manualinterface 5094 which forms part of the drive assembly 5082 while stillutilizing the drive conduit 5462 to permit “top loading” of tools 5042.Other configurations are contemplated.

Referring now to FIGS. 36-38B, in the fifth embodiment of the endeffector 5040, the drive conduit 5462 of the drive assembly 5082 issupported for rotation about the second axis A2 and is operativelyattached to the output gear 5276 of the bevel gearset 5272. Thus, heretoo in this embodiment, the first axis A1 is different from the secondaxis A2 (see also FIG. 35). More specifically, the first axis A1 issubstantially perpendicular to the second axis A2 in this embodiment.However, and as will be appreciated from the eighth embodiment describedbelow, it is contemplated that the first axis A1 could be arrangeddifferently, such as parallel to or even coincident with the second axisA2. Other configurations are contemplated. In the fifth embodiment, thebevel gearset 5272 also provides a reduction in that the output gear5276 is different in configuration than the input gear 5274. Thus, inaddition to translating rotation about the first axis A1 into rotationabout the second axis A2, the bevel gearset 5272 also adjusts rotationaltorque between the first and second axes A1, A2 in this embodiment.

Similar to the fourth embodiment of the end effector 4040 describedabove, the geartrain 5084 in the fifth embodiment also employs aplanetary reduction gearset 5286 arranged along the first axis A1. Here,the reduction gearset 5286 is interposed in rotational communicationbetween the actuator of the rotary instrument 5080 (see FIG. 35;actuator not shown in detail) and the drive conduit 5462 of the driveassembly 5082 such that rotation about the first axis A1 occurs at adifferent (e.g., higher) speed than rotation of the first rotationallock RL1 about the second axis A2. Furthermore, and similar to the thirdembodiment of the end effector 3040 described above, a transmission 5372is provided to facilitate “shifting” between first and second gearsetsGS1, GS2 in order to drive different types of tools 5042 atcorrespondingly different drive ratios DR1, DR2. The specificarrangement of each of these components will be described in greaterdetail below.

The drive assembly 5082 of the fifth embodiment of the end effector 5040employs the first rotational lock RL1 and the axial lock AL tofacilitate securing tools 5042 about the second axis A2. The firstrotational lock RL1 is operatively attached to the drive conduit 5462for concurrent rotation about the second axis A2. The axial lock AL isprovided to releasably secure the tool 5042 for concurrent translationwith the drive conduit 5462 along the trajectory T maintained by thesurgical robot 32 (see FIG. 1), and is operable between the releaseconfiguration ACR where relative movement between the drive assembly5082 and the tool 5042 is permitted along the second axis A2 (see FIG.37A; tool 5042 not shown), and the lock configuration ACL where relativemovement between the drive assembly 5082 and the tool 5042 is restrictedalong the second axis A2 (see FIGS. 37B-37C). The configuration of theaxial lock AL in the fifth embodiment will be described in greaterdetail below

The first rotational lock RL1 comprises a keyed bore in the fifthembodiment, with a generally “square” profile that is shaped to engagecorrespondingly-shaped conduit rotational retainer 5464 formed in a toolbody 5466 arranged between an interface end 5468 and a working end 5470of each of the tools 5042 (see FIG. 36). As will be appreciated from thesubsequent description below, the tool body 5466 could be defined by anysuitable number of components between the interface end 5468 and theworking end 5470. Similarly, it will be appreciated that the interfaceend 5468 and/or the working end 5470 could be defined as a part of thetool body 5466 itself, a separate component that is operatively attachedto the tool body 5466, and/or a component that is releasably attached tothe tool 5042 (e.g., an anchor, a handle assembly, and the like). Otherconfigurations are contemplated. Also formed in the tool body 5466 ofeach of the tools 5042 is a conduit axial retainer 5472 arranged betweenthe interface end 5468 and the working end 5470 that is engaged by theaxial lock AL in the lock configuration ACL (see FIGS. 37B-37C). In thisembodiment, the working end 5470 of the rotary cutting tool 5044corresponds, generally, to the distal cutting end 5044D, and the workingend 5470 of the rotary driving tool 5048 corresponds, generally, to thedistal tip 5050D of the anchor 5050 secured thereto (see FIG. 36; notshown secured). Further, in this embodiment, the interface end 5468corresponds, generally, to the bit interface 5128 of either the rotarycutting tool 5044, the rotary driving tool 5048, or another type of tool5042 secured to the drive assembly 5082 for rotation about the secondaxis A2.

While similar in configuration, it will be appreciated that the conduitrotational retainer 5464 and the conduit axial retainer 5472 of the toolbody 5466 are different from the rotational retainer 5132 and the axialretainer 5130 of the bit interface 5128. Specifically, in the fifthembodiment, rotational retainer 5132 and the axial retainer 5130 of thebit interface 5128 form part of the manual interface 5094 to releasablysecure to the handle assembly (not shown in this embodiment), whereasthe conduit rotational retainer 5464 and the conduit axial retainer 5472of the tool body 5466 facilitate releasable attachment of the tool 5042to the drive assembly 5082 via engagement with the first rotational lockRL1 and the axial lock AL, which effectively serve as the connector inthis embodiment. Furthermore, in the fifth embodiment, each of the tools5042 are configured to engage the same first rotational lock RL1 and thesame axial lock AL.

In order to facilitate cooperation with the transmission 5372 to “shift”between the first and second gearsets GS1, GS2, as noted above anddescribed in greater detail below, the tool body 5466 of the rotarydriving tool 5048 comprises a first shaft portion 5474, and the toolbody 5466 of the rotary cutting tool 5044 comprises a second shaftportion 5476. Both the first shaft portion 5474 and the second shaftportion 5476 are arranged between the interface end 5468 and the workingend 5470 of the tool body 5466 (more specifically, between the conduitaxial retainer 5472 and the conduit rotational retainer 5464 in thisembodiment). Both the first and second shaft portions 5474, 5476 areshaped and arranged to abut, engage, or otherwise contact at least aportion of the selector 5394 of the transmission linkage 5392 of thetransmission 5372. As is described in greater detail below, the selector5394 has a generally tubular profile with a stepped outer profile and acylindrical inner profile arranged along the second axis A2. Because thesecond shaft portion 5476 depends further toward the working end 5470than the first shaft portion 5474 (compare FIGS. 37B-37C), abutmentbetween the selector 5394 of the transmission 5372 and the first shaftportion 5474 facilitates engagement of the first gear set GS1 (see FIG.37B), whereas abutment between the selector 5394 and the second shaftportion 5476 facilitate engagement of the second gear set GS2 (see FIG.37C), as described in greater detail below.

Referring now to FIGS. 35-37C, the drive conduit 5462 of the driveassembly 5082 defines a drive bore, generally indicated at 5478, that isshaped for receiving the working end 5470 of the tool 5042 therethroughand along the second axis A2. Put differently, the drive bore 5478 islarger in size than the driver key 5124 of the rotary driving tool 5048or the distal cutting end 5044D of the rotary cutting tool 5044. Here,the drive assembly 5082 generally defines a proximal inlet 5480 and anopposing distal outlet 5482 with the drive conduit 5462 interposed incommunication between the proximal inlet 5480 and the distal outlet 5482for permitting the working end 5470 of the tool 5042 to be insertedalong the second axis A2 into the proximal inlet 5480 and advancedthrough the drive bore 5478 and out of the distal outlet 5482 toward thesurgical site ST (see FIG. 1) when the axial lock AL is in the releaseconfiguration ACR. As is best depicted in FIG. 37A, the drive conduit5462 in this embodiment defines the distal outlet 5482 of the drive bore5478, but the proximal inlet 5480 is defined by another portion of thedrive assembly 5082 as described in greater detail below. However, otherconfigurations are contemplated, and it will be appreciated that thedrive conduit 5462 could alternatively define the proximal inlet 5480 oreven the entire drive bore 4478 in some embodiments.

In the fifth embodiment, at least a portion of the drive bore 5478arranged adjacent to the distal outlet 5482 defines the first rotationallock RL1, which is shaped to engage at least a portion of the tool 5042(here, the conduit rotational retainer 5464) between the interface end5468 and the working end 5470 when the axial lock AL is in the lockconfiguration ACL such that the working end 5470 of the tool 5042 isarranged distal to the distal outlet 5482 of the drive bore 5478. Heretoo, the interface end 5468 of the tool 5042 is arranged proximal to theproximal inlet 5480 of the drive bore 5478 when the axial lock AL is inthe lock configuration ACL.

As noted above, the geartrain 5084 of the drive assembly 5082 in thefifth embodiment of the end effector 5040 is provided with thetransmission 5372 interposed in rotational communication between theactuator of the rotary instrument 5080 (see FIG. 35; actuator not shownin detail) and the drive conduit 5462. Here too, the transmission 5372comprises the first gearset GS1, the second gearset GS2, and the shiftcollar 5386, which is similarly arranged for movement between the firstcollar position CP1 (see FIG. 37B) and the second collar position CP2(see FIG. 37C). In the first collar position CP1 shown in FIG. 37B, theshift collar 5386 engages the first gearset GS1 to translate rotationbetween the actuator of the rotary instrument 5080 (see FIG. 35;actuator not shown in detail) and the drive conduit 5462 at the firstdrive ratio DR1. In the second collar position CP2 shown in FIG. 37C,the shift collar 5386 engages the second gearset GS2 to translaterotation between the actuator of the rotary instrument 5080 (see FIG.35; actuator not shown in detail) and the drive conduit 5462 at thesecond drive ratio DR2.

As is best shown in FIGS. 37A-37C, like the third embodiment describedabove, here too in the fifth embodiment of the end effector 5040, ratherthan being disposed in meshed engagement with the ring gear 5288, thefirst, second, and third sets of planet gears 5290A, 5290B, 5290C areeach respectively disposed in meshed engagement with the inner teeth5384 of the shift collar 5386 of the transmission 5372. In thisembodiment, however, the inner teeth 5384 of the shift collar 5386 arealso arranged to selectively engage the shaft teeth 5388 of the driverinput shaft 5252 in splined engagement when the shift collar 5386 is inthe second collar position CP2 (see FIG. 37C), whereas in the thirdembodiment the shaft teeth 3388 are formed on the intermediate shaft3256. Rotation of the driver input shaft 5252, which is facilitated bybearings 5262 disposed in the input body 5374, occurs concurrently withthe third sun gear 5292C. Here too in this embodiment, the outer teeth5390 of the shift collar 5386 are similarly arranged to selectivelyengage the ring gear 5288 in splined engagement when the shift collar5386 is in the first collar position CP1 (see FIGS. 37A-37B).

The ring gear 5288 is formed on the intermediate body 5378 in thisembodiment, and movement of the shift collar 5386 occurs substantiallywithin the intermediate body 5378 along the first axis A1 (compare FIGS.37B-37C). To this end, a selector guide 5484 abuts and movesconcurrently with the shift collar 5386 and is similarly shaped so as topermit the braces 5396 to pass therethrough and provide support to thefirst set of pins 5294A. In this embodiment, the braces 5396 thatsupport the first set of pins 5294A are formed on the carrier shaft5422, rather than on the retention shaft 3255 as described in connectionwith the third embodiment of the end effector 3040. The linkage biasingelement 5398 is disposed within the intermediate body 5378 in thisembodiment, and abuts the shift collar 5386 so as to urge the shiftcollar 5386 along the first axis A1 toward the first collar position CP1when the axial lock AL is in the release configuration ACL (see FIG.37A) or when tools 5042 are not otherwise disposed within the driveconduit 5462.

The input gear 5274 of the bevel gearset 5272 is coupled to the carriershaft 5422 which, in turn, is supported for rotation by bearings 5262disposed in a carrier support body 5486 operatively attached to thedrive body 5250 and to the intermediate body 5378. The carrier shaft5422 defines a carrier bore 5488 into which a portion of the selectorguide 5484 is disposed and through which a piston element 5490 extendsalong the first axis A1. The piston element 5490, like the selectorguide 5484, forms part of the transmission linkage 5392 in thisembodiment. The piston element 5490 is supported by bearings 5262disposed in the carrier bore 5488 and in the selector guide 5484, andmoves concurrently with the selector guide 5484 and the shift collar5386 between the first and second collar positions CP1, CP2.

Referring now to FIGS. 37A-38B, in order to facilitate concurrentmovement of the piston element 5490 and the selector guide 5484 alongthe first axis A1 in response to corresponding movement of the selector5394 along the second axis A2, the transmission linkage 5392 alsocomprises piston link members 5492 pivotally coupled to the pistonelement 5490 by piston pins 5494. The piston link members 5492 aregenerally disposed within the drive body 5250 and extend around theselector 5394 in a “wishbone” arrangement. The piston link members 5492are pivotally connected to respective cam link members 5496 by link pins5498, and the cam link members 5496 are pivotally coupled to a pivotmount 5500 by cam pins 5502. The pivot mount 5500 is coupled to thedrive body 5250 by a fastener and is shaped such that the cam pins 5502are generally arranged closer to the output gear 5276 than the link pins5498. The cam link members 5496 each define a respective cam linksurface 5504 (see FIGS. 38A-38B) that is disposed in engagement with andslides along a corresponding bearing seat surface 5506 defined by abearing seat 5508. Here, the bearing seat 5508 supports a bearing 5262about the second axis A2 which, in turn, supports the selector 5394.

As noted above, the selector 5394 has a stepped outer profile and agenerally cylindrical inner profile in the fifth embodiment. Morespecifically, the selector 5394 comprises a selector bore 5510 thatextends between a proximal selector end 5512 and a distal selector end5514, with a first outer portion 5516 that extends from the proximalselector end 5512 to a selector step 5518, and with a second outerportion 5520 that extends from the selector step 5518 to the distalselector end 5514. Here, the second outer portion 5520 extends throughthe bearing 5262 disposed on the bearing seat 5508 with the selectorstep 5518 disposed in abutment with the bearing 5262.

The second outer portion 5520 of the selector 5394 has a generallycylindrical profile and is shaped so as to be received within a secondcylindrical region 5522 of the drive bore 5478 arranged above the firstrotational lock RL1. As noted above, both the drive bore 5478 and thefirst rotational lock RL1 are defined by the output gear 5276 in thisembodiment. The output gear 5276 is rotatably supported by bearings 5262disposed in a lower cover 5524 that is operatively attached to the drivebody 5250. At least a portion of the second outer portion 5520 of theselector 5394 remains disposed within the cylindrical region 5522defined by the output gear 5276 when the shift collar 5386 is in eitherof the collar positions CP1, CP2 (see FIGS. 38A-38C). While the selector5394 is not specifically arranged for concurrent rotation with theoutput gear 5276 in the illustrated embodiment, it will be appreciatedthat the selector bore 5510 can be considered to effectively be anextension of the drive bore 5478 in that it is similarly shaped toreceive a portion of the tool 5042 along the second axis A2 in a “toploading” manner. Here too, it will be appreciated that the selector 5394can be considered to effectively be an extension of the drive conduit5462 in the fifth embodiment of the end effector 5040.

The first outer portion 5516 of the selector 5394 also has a generallycylindrical profile and is shaped so as to be received within a firstcylindrical region 5526 of the retention shaft 5255 which, in thisembodiment, is rotatably supported by bearings 5262 disposed in thedrive body 5250 and serves as a part of the axial lock AL to engage theconduit axial retainer 5472 formed in the tool body 5466 of the tool5042. Here in this embodiment, the first cylindrical region 5526 of theretention shaft 5255 defines the proximal inlet 5480 of the driveassembly 5082 and, like the selector bore 5510, can be considered toeffectively be an extension of the drive bore 5478 in that it issimilarly shaped to receive a portion of the tool 5042 along the secondaxis A2 in a “top loading” manner. Here too, it will be appreciated thatthe retention shaft 5255 can be considered to effectively be anextension of the drive conduit 5462 in the fifth embodiment of the endeffector 5040.

As shown in FIGS. 37A-37C, in this embodiment the connector elementpockets 5310 are formed in the retention shaft 5255 adjacent to theproximal inlet 5480, and are shaped so as to accommodate the axialconnector elements 5306 therein. The axial connector elements 5306 areprovided with a substantially spherical configuration and move radiallywith respect to the second axis A2 in response to movement of the flangemember 5302 along the second axis A2 (compare FIGS. 37A-37C). Here inthis embodiment, the axial ramp surface 5312 is defined by a ramp member5528 formed as a separate component from the flange member 5302 andsupported for rotation relative thereto by a bearing 5262. The rampmember 5528 moves concurrently with the flange member 5302 such thatmovement of the axial ramp surface 5312 relative to the retention shaft5255 causes the axial connector elements 5306 to move radially withrespect to the second axis A2. The flange member 5302, the ramp member5528, the retention shaft 5255, and the axial connector elements 5306cooperate to define the axial lock AL in the fifth embodiment of the endeffector 5040, whereby the axial connector elements 5306 move intoengagement with the conduit axial retainer 5472 of the tool 5042 when inthe lock configuration ACL (see FIGS. 37B-37C), and move away from thesecond axis A2 so as to come out of engagement with the conduit axialretainer 5472 when in the release configuration ACR (see FIG. 37A; tool5042 not shown).

Referring now to FIGS. 36-38B, as noted above, the conduit rotationalretainer 5464 and the conduit axial retainer 5472 are spaced relative toeach other along the tool body 5466 in the same way for both of tools5042 (here, the rotary cutting tool 5044 and the rotary driving tool5048) and in a way that corresponds to the relative spacing between theaxial lock AL and the first rotational lock RL1 of the drive assembly5082. However, because the first shaft portion 5474 of the rotarydriving tool 5048 and the second shaft portion 5476 of the rotarycutting tool 5044 extend in different ways along the tool bodies 5466 ofthe respective tools 5042 between the conduit rotational retainer 5464and the conduit axial retainer 5472, engagement with the proximalselector end 5512 causes the selector 5394 to move to differentpositions along the second axis A2 depending on which tool 5042 issecured to the axial lock AL (compare FIGS. 37A-37C). In the illustratedembodiment, because the second shaft portion 5476 is arranged closer tothe conduit rotational retainer 5464 than the first shaft portion 5474(see FIG. 36), the selector 5394 moves closer to the first rotationallock RL1 when the rotary cutting tool 5044 is secured to the axial lockAL than when the rotary driving tool 5048 is secured to the axial lockAL (compare FIG. 37C with FIG. 37B).

Because movement of the selector 5394 along the second axis A2 resultsin corresponding movement of the shift collar 5386 along the first axisA1 via the transmission linkage 5392, it will be appreciated that thetransmission 5372 in the fifth embodiment similarly “automaticallyshifts” between the gearsets GS1, GS2 based on the configuration of thetool 5042 and without requiring the user to “manually shift” thetransmission 5372. Rather, movement of the selector 5394 along thesecond axis A2 also moves the bearing seat 5508, which causes the camlink members 5496 to pivot about the cam pins 5502 secured to the pivotmount 5500 as the cam link surfaces 5504 slide against the bearing seatsurfaces 5506 (compare FIGS. 38A-38B). This movement of the cam linkmembers 5496 causes the piston link members 5492 to pivot about the linkpins 5498 coupled to the cam link members 5496 which, in turn, causesthe piston element 5490 to move within the carrier bore 5488 of thecarrier shaft 5422 via the connection afforded by the piston pins 5494.As a result, the piston element 5490 moves concurrently with theselector guide 5484 and the shift collar 5386 between the first andsecond collar positions CP1, CP2 (compare FIGS. 38B-38C).

As noted above, the drive conduit 5462 of the drive assembly 5082 isconfigured to releasably secure different types of tools 5042 in a “toploading” manner. This configuration affords significant advantages forcertain types of surgical procedures and/or with certain types of tools5042 based, among other things, on the amount of articulation availablevia the robotic arm 36 relative to the base 34 and/or relative to thesurgical site ST (see FIG. 1). More specifically, “top loading” mayadvantageously be utilized in scenarios where it is undesirable orimpractical to substantially move or otherwise reposition the endeffector to provide sufficient clearance relative to the surgical siteST in order to remove one tool and/or subsequently attach another tool,or where the approach utilized by the surgeon results in the robotic arm36 having been articulated relative to the base 34 in a way that issufficient for one type of tool but may not be desirable or viable for adifferent type of tool. Put differently, it is contemplated that certaintypes of tools may require less overall movement of the robotic arm 36to facilitate attachment in a “top loading” manner than in a “bottomloading” manner, and it is contemplated that the “top loading” mannercan provide improved opportunities for utilizing the articulation rangeof the robotic arm 36 relative to the base 34 and the surgical site STthan could otherwise be utilized in a “bottom loading” manner.

It will be appreciated that the forgoing examples are illustrative andnon-limiting, and that the “bottom loading” manner described inconnection with the first, second, third, and fourth embodiments canalso be utilized with different tools that are sequentially utilizedduring a surgical procedure, and may even be preferable to the “toploading” manner in certain situations. Similarly, it will be appreciatedthat movement of the end effector along the trajectory T in order tofacilitate changing between tools may occur or may even be desirable incertain scenarios, both for end effectors that are configured to securetools in the “bottom loading” manner and also for end effectors that areconfigured to secure tools in the “top loading” manner. Nevertheless,the “top loading” manner afforded by the fifth embodiment of the endeffector 5040 may be particularly advantageous where different,sequentially-utilized tools 5042 differ in length enough that anundesirable amount of movement along the trajectory T would otherwise beneeded to completely remove one tool 5042 and provide sufficientclearance to attach another tool 5042 in a “bottom loading” manner.

As noted above, a sixth embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 39A-44B. In the description that follows,the structure and components of the sixth embodiment that are the sameas or that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 6000. Because many of the components andfeatures of the sixth embodiment of the end effector 6040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the sixthembodiment of the end effector 6040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings.

Thus, unless otherwise indicated below, the description of the firstembodiment of the end effector 40 may be incorporated by reference withrespect to the sixth embodiment of the end effector 6040 withoutlimitation. Likewise, certain components and features of the sixthembodiment of the end effector 6040 that are similar to correspondingcomponents and features of previously-described embodiments may bereferred to or otherwise depicted in the drawings as provided with thesame reference numerals increased by 1000 plus another 1000 for everyintervening embodiment (e.g., for the sixth embodiment, componentsdescribed in connection with the fifth embodiment would be increased by1000, components described in connection with the fourth embodimentwould be increased by 2000, components described in connection with thethird embodiment would be increased by 3000, and components described inconnection with the second embodiment would be increased by 4000).

Referring now to FIGS. 39A-44B, the sixth embodiment of the end effector6040 is generally shown comprising the mount 6078, the rotary instrument6080 and its actuator 6166 (depicted schematically), and the driveassembly 6082. When compared with the first embodiment described above,the sixth embodiment of the end effector 6040 generally employs adifferently-configured trigger assembly 6088 and drive assembly 6082,and is configured to secure tools 6042 in a “top loading” manner throughthe drive conduit 6462 in a way that is similar to the fifth embodiment.Each of these components will be described in greater detail below.

As is best shown in FIGS. 39A-40, in the sixth embodiment, the driveassembly 6082 is similarly configured for releasable attachment to therotary instrument 6080 via the coupling 6230 such that the second axisA2 can be moved relative to the first axis A1 by positioning the driveassembly 6082 in different ways about the first axis A1. The triggerassembly 6088 in the sixth embodiment employs a grip 6090 and an inputtrigger 6092 which are similar in construction to the third embodimentof the trigger assembly 3088 described above. Here too, the frame 6134of the trigger assembly 6088 is provided with the first frame body 6362and the second frame body 6364. The first frame body 6362 is similarlycoupled to the retainer 6136 for concurrent movement between theplurality of trigger assembly positions, including the first triggerassembly position P1 (see FIGS. 39A-39B) and the second trigger assemblyposition P2 (see FIG. 39C). Moreover, the second frame body 6364likewise supports the grip 6090 and the input trigger 6092 for movementrelative to the first frame body 6362 between the plurality of grippositions, including the first grip position G1 (see FIG. 39A) and thesecond grip position G2 (see FIGS. 39B-39C). However, in thisembodiment, the second frame body 6364 is arranged for pivoting movementrelative to the first frame body 6362 between the first and second grippositions G1, G2 as opposed to the translational movement described andillustrated in connection with the third embodiment.

When in the first grip position G1 as shown in FIG. 39A, at least aportion of the second frame body 6364 limits access to the manualinterface 6094 which, like the fifth embodiment described above, isrealized by the bit interface 6128 of the tool 6042 that is secured tothe drive conduit 6462 in the “top loading” manner in this embodiment.Furthermore, when in the first grip position G1, the input trigger 6092is similarly arranged for engagement by the user to drive the rotaryinstrument 6080 to rotate whichever tool 6042 is secured to the driveconduit 6462 about the second axis A2, as described in greater detailbelow. However, when in the second grip position G2 as shown in FIG.39B, the second frame body 6364 is disposed in spaced relation to themanual interface 6094 to facilitate receiving applied force from theuser to rotate the tool 6042 about the second axis A2. The second framebody 6364 is also arranged for concurrent movement with the first framebody 6362 between the plurality of trigger assembly positions P1, P2independent of movement between the plurality of grip positions G1, G2(compare FIGS. 39A-39C).

In the sixth embodiment of the end effector 6040, the second frame body6364 is arranged for pivoting movement between the first grip positionG1 (see FIG. 39A) and the second grip position G2 (see FIG. 39B), thepivoting movement occurring along pivot axis VA arranged substantiallyperpendicular to both the first axis A1 and the second axis A2. To thisend, and as is best shown in FIG. 41, a pivot pin 6530 pivotally couplesthe first frame body 6362 and the second frame body 6364 together, and atensioner 6532 operatively attached to the first frame body 6362 extendsinto a tensioner slot 6534 formed in the second fame body 6364 to limitmovement of the second frame body 6364 relative to the first frame body6362. Here, the tensioner slot 6534 has an arc-shaped profile thateffectively defines the first and second grip positions G1, G2, and canalso be utilized to provide an adjustable amount of resistance torotation about the pivot axis VA, or to otherwise “lock” the secondframe body 6364 relative to the first frame body 6362 at or between thefirst and second grip positions G1, G2.

As shown in FIG. 41, in the sixth embodiment, the linkage 6178 of thetrigger assembly 6088 employs a cable arrangement, generally indicatedat 6536, to facilitate movement of the piston 6182 in response tocorresponding movement of the input trigger 6092 between the first andsecond input positions I1, I2 (first input position I1 shown in FIG.41). To this end, the cable arrangement 6536 comprises a flexibleconduit 6538 that extends between a pair of tensioner assemblies 6540respectively coupled to the first and second frame bodies 6362, 6364. Awire 6542 (depicted schematically in FIG. 41) is coupled to the inputtrigger 6092 and the piston 6182, and extends through the tensionerassemblies 6540 and the flexible conduit 6538 such that movement of theinput trigger 6092 results in corresponding movement of the piston 6182which, in turn, engages against and moves the fork guide 6188 of therotary instrument 6080 (see FIG. 40). This configuration facilitates thepivoting movement of the second frame body 6364 relative to the firstframe body 6362 while ensuring that the input trigger 6092 can be movedbetween the first and second input positions I1, I2 in either the firstgrip position G1 (see FIG. 39A), the second grip position G2 (see FIG.39B), or any other grip position therebetween.

Referring now to FIGS. 40 and 42B, a total of three different exemplarytypes of tools 6042 are depicted in connection with the sixth embodimentof the end effector 6040, each of which are configured for “top loading”into the drive conduit 6462 of the drive assembly 6082 along the secondaxis A2 like the fifth embodiment of the end effector 5040 describedabove. More specifically FIG. 40 shows a dissector tool 6544 and aversion of the rotary driving tool 6048 for use in driving the anchor6050, and FIG. 42B schematically depicts an alignment tool 6546. As isdescribed in greater detail below, the rotary driving tool 6048 hasstructural differences compared to previously-described embodiments, butis nevertheless configured for releasable attachment to the firstrotational lock RL1 and the axial lock AL of the drive assembly 6082 ina “top loading” manner so as to extend through the drive conduit 6462and be driven about the second axis A2 via the rotary instrument 6080.The dissector tool 6544 and the alignment tool 6546, while stillconfigured to be received within the drive conduit 6462 along the secondaxis A2, are not configured to attach to the first rotational lock RL1or the axial lock AL in the illustrated embodiment. Here, the dissectortool 6544 and the alignment tool 6546 are realized as “passive” tools6042 in that they can be inserted into the drive conduit 6462 along thesecond axis A2 and positioned relative to the surgical site ST by thesurgical robot 32 (see FIG. 1), but are not driven by the rotaryinstrument 6080 as “active” tools 6042 like the rotary driving tool6048. Other types of “active” and/or “passive” tools 6042, besides thoseintroduced above, are contemplated by the present disclosure.

In the representative examples illustrated in connection with the sixthembodiment, “passive” tools 6042 such as the dissector tool 6544 and thealignment tool 6546 are permitted to freely rotate about the second axisA2 independent of the drive conduit 6462, and can translate away fromthe drive conduit 6462 along the second axis A2. Put differently, the“passive” tools 6042 do not engage either the first rotational lock RL1or the axial lock AL in this embodiment, but can nevertheless beinserted into the drive conduit 6462 along the second axis A2 and can beremoved from the drive conduit 6462 without requiring the user tointeract with the axial lock AL. In contrast to “passive” tools 6042,“active” tools 6042 do engage both the first rotational lock RL1 and theaxial lock AL, rotate concurrently with the drive conduit 6462 about thesecond axis A2, and require the user to interact with the axial lock ALto facilitate removal from the drive conduit 6462.

While the “passive” tools 6042 illustrated in connection with the sixthembodiment are configured so as to be received within the drive conduit6462 along the second axis A2 without engaging the first rotational lockRL1 or the axial lock AL, it is contemplated that certain types of“passive” tools 6042 could be configured to engage the axial lock AL butnot the first rotational lock RL1 such that free rotation would bepermitted about the second axis A2, but translation along the secondaxis A2 would be inhibited.

As is best depicted in FIGS. 40 and 43B, the dissector tool 6544generally comprises a dissection shaft 6548 and a dissection cannula6550. The dissection shaft 6548 is shaped to extend through thedissection cannula 6550 between a knob 6552 arranged at the interfaceend 6468 and a pointed tip 6554 arranged at the working end 6470. Thedissection cannula 6550, in turn, comprises a guide body 6556 whichextends from a stop element 6558 to a toothed end 6560, with a generallycylindrical profile delineated by a first tapered step 6562 adjacent tothe stop element 6558 and a second tapered step 6564 adjacent to thetoothed end 6560. Here, the guide body 6556 of the dissection cannula6550 serves as the tool body 6466 and can be inserted into the driveconduit 6462 along the second axis A2 until abutment between the stopelement 6558 and the drive assembly 6082 limits further translationalmovement along the second axis A2. The dissection cannula 6550 canrotate freely within the drive conduit 6462. The dissection shaft 6548can be inserted into the dissection cannula 6550 along the second axisA2 until the pointed tip 6554 of the dissection shaft 6548 extendsbeyond the toothed end 6560 of the guide body 6556. Here too, thedissection shaft 6548 can be rotated freely about the second axis A2within the dissection cannula 6550. The knob 6552 of the dissectionshaft 6548 is shaped and arranged so as to be grasped by the user, suchas to facilitate advancing or retracting the dissection shaft 6548through the dissection cannula 6550. It is also contemplated that theknob 6552 could be employed to facilitate moving or otherwisepositioning the end effector 6040 relative to the base 34 of thesurgical robot 32 (see FIG. 1) such as in various types of “haptic” or“free” modes that allow articulation of the robotic arm 36 in responseto applied force acting on the end effector 6040, which may be utilizedduring certain steps of surgical procedures to permit movement relativeto the surgical site ST (e.g., along the trajectory T or based onvarious types of virtual boundaries). Thus, the user can grasp the knob6552 and apply force in certain directions to move the end effector 6040when the surgical robot 32 (see FIG. 1) operates in one or more “haptic”or “free” modes.

Referring now to FIG. 42B, the alignment tool 6546 is schematicallydepicted as being disposed within the drive conduit 6462 of the driveassembly 6082. In this illustrative embodiment, the guide body 6556 ofthe alignment tool 6546 is analogous to the tool body 6466 and extendsfrom the stop element 6558 to a module end 6566 arranged distal to thedrive conduit 6462 along the second axis A2 when the stop element 6558abuts the drive assembly 6082. However, as will be appreciated from thesubsequent description below, the module end 6566 could be arrangeddifferently, such as to be disposed within the drive bore 6478, withoutdeparting from the scope of the present disclosure.

A light source, generally indicated at 6568, is coupled to the guidebody 6556 adjacent to the module end 6566 of the alignment tool 6546 inthe illustrated embodiment. The light source 6568 is configured to emitlight L toward the surgical site ST along a light path LP that issubstantially aligned with the second axis A2 (and, thus, the trajectoryT) when the alignment tool 6546 is inserted along the second axis A2into the drive conduit 6462 of the drive assembly 6082. Here, anactivation button 6570 is coupled to the stop element 6558 may bedisposed in electrical communication with the light source 6568 tofacilitate selectively emitting light L when actuated by the user. Abattery or another type of power source (not shown) may be disposedwithin the guide body 6556 to power the light source 6568. The lightsource 6568 may be configured as a laser diode in some embodiments.Depending on the specific configuration of the light source 6568,emitted light L may visualized as a “dot” aligned along the trajectory Tthat is projected onto the surgical site ST, and may also be visualizedas a “beam” aligned along the light path LP (and, thus, along thetrajectory T) in some embodiments. It will be appreciated that the lightsource 6568 can be configured to emit light L at any suitable wavelengthsufficient to be visualized in any suitable way. By way of non-limitingexample, light L can be visualized directly (e.g., within the visiblespectrum) and/or visualized indirectly (e.g., with a camera feedpresented on a display screen).

Furthermore, it will be appreciated that a variety of different types oflight sources 6568 may be utilized, in addition to or in the place ofthe light sources 6568 illustrated throughout the drawings and describedherein. By way of non-limiting example, light sources may be provide todirect or otherwise emit light L generally toward the surgical site ST,such as for general illumination purposes. In some embodiments, lightsources 6568 may be configured similar to as is described in U.S. PatentApplication Publication No. US 2013/0053648 A1, entitled “Surgical Toolfor Selectively Illuminating a Surgical Volume,” the disclosure of whichis hereby incorporated by reference in its entirety. It will beappreciated that other types and configurations of anchors 50, and theassociated installation thereof, are contemplated by the presentdisclosure. Furthermore, it will be appreciated that other types ofoptical devices (e.g., cameras) could be employed in some embodiments.Other configurations are contemplated.

Because the alignment tool 6546 is configured for removable attachmentto the drive conduit 6462 of the drive assembly 6082, the light source6568 and/or the entire alignment tool 6546 may be configured as a“single use” component that is discarded for recycling or reprocessingafter the surgical procedure. Alternatively, the light source 6568and/or the alignment tool 6546 may be configured as a “multiple use”component that is sterilized after the surgical procedure. Otherconfigurations are contemplated.

In the representative embodiment illustrated in FIG. 42A, the lightsource 6568 is not configured for removable attachment to the driveconduit 6462 of the drive assembly 6082. Rather, in this embodiment,light source 6568 and the activation button 6570 are coupled to thesecond frame body 6364 of the trigger assembly 6088 for concurrentmovement relative to the first frame body 6362. Here, when the secondframe body 6364 is arranged in the first grip position G1 as depicted inFIG. 42A, light L can be emitted by the light source 6568 through thedrive conduit 6462, along the light path LP aligned with the second axisA2 (and, thus, the trajectory T) toward the surgical site ST. With thisconfiguration, the light source 6568 can be utilized both when tools6042 are removed from the drive conduit 6462 and also when tools 6042that are cannulated along the second axis A2 (e.g., to receive aguidewire GW; not shown in this embodiment) are positioned within thedrive conduit 6462. Furthermore, similar to as is described above inconnection with FIG. 42B, the light source 6568 could be of other types,configurations, and the like, and may comprise a variety of differentoptical devices (e.g., cameras, lights for general illumination, and thelike). Other configurations are contemplated.

As shown in FIGS. 43A-43C, the geartrain 6084 of the drive assembly 6082similarly employs the bevel gearset 6272 in the sixth embodiment totranslate rotation about the first axis A1 into rotation about thesecond axis A2. To this end, the input gear 6274 is coupled to thecarrier shaft 6422 for concurrent rotation about the first axis A1, andthe output gear 6276 is coupled to the drive conduit 6462 for concurrentrotation about the second axis A2, with the drive conduit 6462 supportedfor rotation by bearings 6262 disposed in the drive body 6250. Like thefifth embodiment of the end effector 5040 described above, the bevelgearset 6272 also affords a reduction between the input gear 6274 andthe output gear 6276, and utilizes a planetary type reduction gearset6286 arranged along the first axis A1. Here, rotation of the driverinput shaft 6252, which is facilitated by bearings 6262 disposed in theinput body 6374, occurs concurrently with the third sun gear 6292C. Thecarrier shaft 6422 is supported for rotation about the first axis A1 bybearings 6262 disposed in the intermediate body 6378 and is operativelyattached to the first set of pins 6294A. Each of the first, second, andthird sets of planet gears 6290A, 6290B, 6290C are disposed in meshedengagement with the ring gears 6288, which is formed in the input body6374 in this embodiment.

Referring now to FIGS. 40 and 43A-44B, in the sixth embodiment of theend effector 6040, the first rotational lock RL1 is realized as asplined bore defined by drive splines 6572 formed in the drive conduit6462 adjacent to the proximal inlet 6480 of the drive bore 6478. Thedrive splines 6572 releasably engage with corresponding outer transitionsplines 6574 of a transition gear 6576 that are configured forreleasable attachment to the axial lock AL to facilitate retention of“active” tools 6042, as described in greater detail below. Thetransition gear 6576 also comprises inner transition splines 6578 thatreleasably engage with corresponding tool splines 6580 formed in thetool body 6466 of “active” tools 6042. The drive splines 6572 formed inthe drive conduit 6462, have a generally frustoconical profile thattapers inwardly relative to the second axis A2 toward the distal outlet6482. The outer transition splines 6574 of the transition gear 6576 areshaped complimentarily to the drive splines 6572 so as to be disposed inmeshed engagement therewith (see FIGS. 43C-43D). The inner transitionsplines 6578 also have a generally frustoconical profile, but tapersinwardly relative to the second axis A2 toward the proximal inlet 6480rather than toward the distal outlet 6482 like the drive splines 6572.Here too, the tool splines 6580 formed in the tool body 6466 of “active”tools 6042 are shaped complimentarily to the inner transition splines6578 of the transition gear 6576 so as to be disposed in meshedengagement therewith (see FIGS. 43C-43D).

The drive splines 6572 are arranged proximal to a drive shelf 6582formed in the drive conduit 6462. The drive shelf 6582 has a flat,ring-shaped profile that faces away from the distal outlet 6482 and isshaped and arranged to engage against an abutment face 6584 formed onthe tool body 6466 of “active” tools 6042 secured via the axial lock AL,as described in greater detail below. This configuration helps ensurethat the tool body 6466 is positioned properly relative to the driveconduit 6462 along the second axis A2 when the axial lock AL is in thelock configuration ACL by limiting how far the tool body 6466 can beadvanced into the drive bore 6478.

As is best shown in FIGS. 43C-43D, the tool body 6466 of “active” tools6042 in the sixth embodiment also comprises an engagement flange 6586arranged between the abutment face 6584 and the tool spline 6580. Theengagement flange 6586 defines a flange face 6588 facing away from theabutment face 6584. Here, the flange face 6588 is shaped and arranged toengage against a transition face 6590 of the transition gear 6576. Thetransition gear 6576 also comprises a handling portion 6592 that extendsaway from the transition face 6590 to a handling face 6594, and definesa transition bore 6596 that extends along the second axis A2 between thehandling face 6594 and the transition face 6590 with the innertransition splines 6578 formed in or otherwise defined by the transitionbore 6596. A transition notch 6598 arranged between the handling portion6592 and the outer transition splines 6574 of the transition gear 6576is provided to facilitate restricting relative movement with and betweenboth the drive conduit 6462 and the tool body 6466 of “active” tools6042 when the axial lock AL is in the lock configuration ACL to securethe tool 6042 for concurrent rotation with the drive conduit 6462 aboutthe second axis A2.

While not formed as a portion of the tool 6042 in the sixth embodiment,the transition notch 6598 serves as the conduit axial retainer 6472 viaengagement with a pair of axial connector elements 6306 that form partof a locking assembly, generally indicated at 6600. As is best shown inFIGS. 43A and 43D-44B, the locking assembly 6600 comprises a lockinghousing 6602 that is operatively attached to the drive conduit 6462 forconcurrent rotation about the second axis A2. The locking housing 6602effectively defines the proximal inlet 6480 of the drive bore 6478 andis likewise shaped to receive the working end 6470 of the tool 6042therethrough along the second axis A2. The locking housing 6602 isprovided with a slider slot 6604 in which a slider element 6606 issupported for movement in a direction substantially perpendicular to thesecond axis A2. The axial connector elements 6306 are operativelyattached to the slider element 6606 for concurrent movement relative tothe locking housing 6602, and cooperate to define the axial lock AL viaengagement with the transition notch 6598.

As is best shown in FIGS. 44A-44B, the slider element 6606 defines guideslots 6608 in which guide pins 6610 operatively attached to the lockinghousing 6602 are disposed. Here, cooperation between the guide slots6608 and the guide pins 6610 retains the slider element 6606 within theslider slot 6604 for movement relative to the second axis A2 between afirst slider element position SL1 associated with the releaseconfiguration ACR (see FIG. 44B), and a second slider element positionSL2 associated with the lock configuration ACL (see FIG. 44A). The axialconnector elements 6306 coupled to the slider element 6606 are disposedcloser to the second axis A2 when in the second slider element positionSL2 than in the first slider element position SL1. A slider biasingelement 6612 disposed within the slider slot 6604 and interposed betweenthe slider element 6606 and the locking housing 6602 urges the sliderelement 6606 toward the second slider element position SL2. A sliderengagement button 6614 is provided integrally formed with the sliderelement 6606 and is arranged for engagement by the user to move from thesecond slider element position SL2 to the first slider element positionSL1. The slider engagement button 6614 is arranged generallyperpendicular to a stop face 6616 defined by the locking housing 6602,which serves as the portion of the drive assembly 6082 that abuts thestop element 6558 of “passive” tools 6042 (see FIG. 43B).

Referring now to FIGS. 43C-44B, in order to facilitate attachment of“active” tools 6042 to the drive conduit 6462 of the drive assembly6082, the working end 6470 can be inserted into the proximal inlet 6480of the drive bore 6478 and advance along the second axis A2 to move outof the distal outlet 6482 which, in the sixth embodiment, is defined bya lower cap 6618 that is operatively attached to the drive conduit 6462adjacent to the lower cover 6524. Here, the tool body 6466 can beadvanced into the drive bore 6478 until the abutment face 6584 of thetool 6042 comes into engagement with the drive shelf 6582 of the driveconduit 6462. Next, the user can grasp the handling portion 6592 of thetransition gear 6576 to pass the interface end 6468 of the tool 6042through the transition bore 6596 and advance the transition gear 6576along the second axis A2 to bring the transition face 6590 toward andinto abutment with the flange face 6588 of the tool body 6466.Alternatively, the user can “seat” the transition gear 6576 onto thetool 6042 to bring the inner transition splines 6578 into meshedengagement with the tool splines 6580 prior to inserting the working end6470 into the proximal inlet 6480 of the drive bore 6478. The drivesplines 6572 engage and mesh with the outer transition splines 6574, andthe inner transition splines 6578 engage and mesh with the tool splines6580, in order to define the first rotational lock RL1 such that thedrive conduit 6462, the transition gear 6576, and the tool 6042 rotateconcurrently about the second axis A2. Furthermore, when the transitionface 6590 of the transition gear 6576 abuts the engagement flange 6586of the tool 6042, the axial lock AL moves to the lock configuration ACL,defined by engagement between the axial connector elements 6306 carriedby the slider element 6606 and the transition notch 6598 formed in thetransition gear 6576, to prevent relative movement along the second axisA2 between the tool 6042, the transition gear 6576, and the driveconduit 6462.

As noted above, a seventh embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 45-48B. In the description that follows, thestructure and components of the seventh embodiment that are the same asor that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 7000. Because many of the components andfeatures of the seventh embodiment of the end effector 7040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the seventhembodiment of the end effector 7040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings.

Thus, unless otherwise indicated below, the description of the firstembodiment of the end effector 40 may be incorporated by reference withrespect to the seventh embodiment of the end effector 7040 withoutlimitation. Likewise, certain components and features of the seventhembodiment of the end effector 7040 that are similar to correspondingcomponents and features of previously-described embodiments may bereferred to or otherwise depicted in the drawings as provided with thesame reference numerals increased by 1000 plus another 1000 for everyintervening embodiment (e.g., for the seventh embodiment, componentsdescribed in connection with the sixth embodiment would be increased by1000, components described in connection with the fifth embodiment wouldbe increased by 2000, components described in connection with the fourthembodiment would be increased by 3000, components described inconnection with the third embodiment would be increased by 4000, andcomponents described in connection with the second embodiment would beincreased by 5000).

Referring now to FIGS. 45-48B, the seventh embodiment of the endeffector 7040 is generally shown comprising the mount 7078, the rotaryinstrument 7080 and its actuator 7166 (depicted schematically), and thedrive assembly 7082. When compared with the first embodiment describedabove, the seventh embodiment of the end effector 7040 generally employsthe same type of trigger assembly 7088, and its drive assembly 7082 isconfigured to secure tools 7042 in a “top loading” manner through thedrive conduit 7462 in a way that is similar to the fifth and sixthembodiments, as described in greater detail below.

In the seventh embodiment, two exemplary types of tools 7042 aredepicted in FIG. 46, including a differently-configured rotary cuttingtool 7044 and a scalpel tool 7620. Here, the rotary cutting tool 7044 isrealized as an “active” tool 7042 that is adapted for concurrentrotation with the drive conduit 7462 about the second axis A2, and thescalpel tool 7620 is realized as a “passive” tool 7042. Like thedissector tool 6544 described above in connection with the sixthembodiment of the end effector 6040, the illustrated scalpel tool 7620and the rotary cutting tool 7044 similarly employ knobs 7552 arranged atthe interface end 7468 of the tool body 7466. However, and as isillustrated in FIG. 47C, the knob 7552 of the rotary cutting tool 7044is arranged for independent rotation relative to the tool body 7466 viaa bearing 7262 operatively attached to the interface end 7468. Here inthis embodiment, the illustrated rotary cutting tool 7044 does notcomprise any type of manual interface, and is rotated about the secondaxis A2 via engagement with the drive conduit 7462 while retained by thefirst rotational lock RL1 and the axial lock AL of the drive assembly7082, each of which are described in greater detail below. Putdifferently, the rotary cutting tool 7044 is not configured in thisembodiment so as to be rotated “manually” by the user about the secondaxis A2 and instead utilizes the knob 7552 which, here, can be graspedby the user while the rotary instrument 7080 is utilized to rotate theworking end 7470 about the second axis A2 without translating rotationback to the user's hand. However, it will be appreciated that otherconfigurations are contemplated, and one or more tools 7042 could beprovided with manual interfaces similar to those illustrated anddescribed in connection with previous embodiments.

Referring now to FIGS. 47A-48B, in the seventh embodiment of the endeffector 7040, the drive assembly 7082 likewise utilizes the driveconduit 7462 to facilitate “top loading” of tools 7042 to be drivenabout the second axis A2 via torque generated by the rotary instrument7080. Here too, the geartrain 7084 comprises a planetary-type reductiongearset 7286 interposed between the driver input shaft 7252 and thecarrier shaft 7422, and an addition reduction is provided by the bevelgearset 7272 in that the input gear 7274 and the 7276 have differentconfigurations from each other. While the input gear 7274 is coupled tothe carrier shaft 7422, the output gear 7276 is coupled to a taperconduit 7622 that forms part of a collet mechanism 7624 configured tofacilitate axial and rotational retention of “active” tools 7042 andserving as the first rotational lock RL1 and the axial lock AL in theseventh embodiment. Here, the taper conduit 7622 is supported forrotation about the second axis A2 via bearings 7262 disposed in thedrive body 7250 of the drive assembly 7082, and rotates concurrentlyabout the second axis A2 with the lower cap 7618 and an upper cap 7626(see FIGS. 47A-47C). The taper conduit 7622 has a taper bore 7628 with agenerally frustoconical profile that increases in radius relative to thesecond axis A2 in a direction away from the proximal inlet 7480 andtoward the distal outlet 7482. A correspondingly-shaped collet 7630 isdisposed within the taper bore 7628, generally defines the drive conduit7462 in this embodiment, and has a resilient collet body 7632 whichextends from a proximal collet end 7634 to a distal collet end 7636.

As is best shown in FIG. 47A, the resilient collet body 7632 is realizedas a unitary, one-piece component with an “ER collet” configuration, anddefines a collet bore 7638 with a generally cylindrical profile which,in turn, defines the drive bore 7478. As is described in greater detailbelow, the resilient collet body 7632 is configured to deflect at leastpartially radially-inwardly toward the second axis A2 to facilitateretention of the tool 7042 via engagement with the tool body 7466. Thecollet 7630 also comprises a proximal collet portion 7640 which isshaped to be received within the taper bore 7628 of the taper conduit7622, a distal collet portion 7642 which similarly has a generallyfrustoconical profile that decreases in radius relative to the secondaxis A2 in a direction away from the proximal inlet 7480 and toward thedistal outlet 7482, and a collet notch 7644 arranged between theproximal collet portion 7640 and the distal collet portion 7642.

The collet notch 7644 receives a collet retainer 7646 of a collet knob7648 that is arranged for engagement by the user. Here, the collet knob7648 forms part of a collet tensioner 7650 of the collet mechanism 7624which is coupled to the collet 7630 and is arranged for movement betweena first tensioner position TP1 (see FIGS. 47B and 48B) and a secondtensioner position TP2 (see FIGS. 47A and 48A). The first tensionerposition TP1 is associated with the release configuration ACR of theaxial lock AL where relative movement is permitted between the tool 7042and the collet 7630, and the second tensioner position TP2 is associatedwith the lock configuration ACL of the axial lock AL where relativemovement is restricted between the tool 7042 and the collet 7630.

As is best depicted in FIGS. 47A and 48A-48B, the collet knob 7648 ofthe collet tensioner 7650 is operatively attached to the lower cap 7618of the drive assembly 7082 via a pair of knob guides 7652 (e.g.,fasteners) which extend through knob slots 7654 formed in the colletknob 7648. The knob slots 7654 are provided with a generally helicalprofile with first and second knob slot ends 7656, 7658 shaped to retainthe knob guides 7652 and thereby define the first and second tensionerpositions TP1, TP2, respectively, of the collet tensioner 7650. A knobbiasing element 7660 interposed between the collet knob 7648 and thelower cap 7618 urges the collet tensioner 7650 toward the firsttensioner position TP1 (see FIGS. 47B and 48B). This configurationallows the knob guides 7652 to “detent” into and remain seated withinthe first and second knob slot ends 7656, 7658 until the user rotatesthe collet knob 7648 relative to the lower cap 7618. Put differently,the user can rotate the collet knob 7648 to move the axial lock ALbetween the release configuration ACR (see FIGS. 47B and 48B) and thelock configuration ACL (see FIGS. 47A and 48A).

Because of the configuration of the knob slots 7654 described above,rotation of the collet knob 7648 via force applied by the user alsoresults in translation of the collet knob 7648 along the second axis A2.Moreover, because of the engagement between the collet retainer 7646 ofthe collet knob 7648 and the collet notch 7644 of the collet 7630,rotation of the collet knob 7648 also results in translation of thecollet 7630 along the second axis A2 within the taper bore 7628 of thetaper conduit 7622. Here, when the user engages the collet knob 7648 tomove the collet tensioner 7650 from the first tensioner position TP1(see FIGS. 47B and 48B) to the second tensioner position TP2 (see FIGS.47A, 47C, and 48A), the collet 7630 moves toward the proximal inlet 7480and is compressed radially-inwardly toward the second axis A2 viaengagement between the proximal collet portion 7640 and the taper bore7628. When the tool body 7466 of the tool 7042 is disposed within thedrive bore 7478 defined by the collet bore 7638, this compression urgesat least a portion of the resilient collet body 7632 against the toolbody 7466 to “clamp” the tool 7042 to the drive conduit 7462, therebyeffecting operation of both the first rotational lock RL1 and the axiallock AL for “active” tools 7042. For “passive” tools, such as thescalpel tool 7620, the collet tensioner 7650 is utilized in the firsttensioner position TP1 and is not moved to the second tensioner positionTP2.

In the seventh embodiment of the end effector 7040, both “active” and“passive” tools 7042 can be inserted into and removed from the driveconduit 7462 along the second axis A2 in the “top loading” manner. Tothis end, when the collet tensioner 7650 is in the first tensionerposition TP1 (see FIG. 47B), the working end 7470 can be placed into theproximal inlet 7480 and advanced along the second axis A2 into thecollet bore 7638 (which, in this embodiment, defines the drive bore7478) and out of the distal outlet 7482 (which, in this embodiment, isdefined by the collet knob 7648). As shown in FIG. 48C, certain types oftools 7042 may comprise a stop mount 7662 at the interface end 7468which is shaped and arranged to abut the stop face 7616 (which, in thisembodiment, is defined by the upper cap 7626) and thereby prevent thetool 7042 from being advanced further into the drive bore 7478 along thesecond axis A2. However, it will be appreciated that otherconfigurations are contemplated, and the position of the tool 7042 alongthe second axis A2 can be limited relative to the drive conduit 7462 inother ways. If the tool 7042 is of the “active” configuration, thecollet tensioner 7650 can then be moved from the first tensionerposition TP1 to the second tensioner position TP2 to facilitate drivingthe tool 7042 about the second axis A2 via the rotary instrument 7080.If, however, the tool is of the “passive” configuration, the collettensioner 7650 can remain in the first tensioner position TP1 as notedabove.

As noted above, an eighth embodiment of the end effector of the surgicalsystem 30 is shown in FIGS. 49A-63F. In the description that follows,the structure and components of the eighth embodiment that are the sameas or that otherwise correspond to the structure and components of thefirst embodiment of the end effector 40 are provided with the samereference numerals increased by 8000. Because many of the components andfeatures of the eighth embodiment of the end effector 8040 aresubstantially similar to those of the first embodiment of the endeffector 40 described above, for the purposes of clarity, consistency,and brevity, only certain specific differences between the eighthembodiment of the end effector 8040 and the first embodiment of the endeffector 40 will be described below, and only some of the components andfeatures common between the embodiments will be discussed herein anddepicted in the drawings.

Thus, unless otherwise indicated below, the description of the firstembodiment of the end effector 40 may be incorporated by reference withrespect to the eighth embodiment of the end effector 8040 withoutlimitation. Likewise, certain components and features of the eighthembodiment of the end effector 8040 that are similar to correspondingcomponents and features of previously-described embodiments may bereferred to or otherwise depicted in the drawings as provided with thesame reference numerals increased by 1000 plus another 1000 for everyintervening embodiment (e.g., for the eighth embodiment, componentsdescribed in connection with the seventh embodiment would be increasedby 1000, components described in connection with the sixth embodimentwould be increased by 2000, components described in connection with thefifth embodiment would be increased by 3000, components described inconnection with the fourth embodiment would be increased by 4000,components described in connection with the third embodiment would beincreased by 5000, and components described in connection with thesecond embodiment would be increased by 6000).

Referring now to FIGS. 49A-63F, the eighth embodiment of the endeffector 8040 is generally shown comprising the mount 8078, the rotaryinstrument 8080 and its actuator 8166, and the drive assembly 8082. Whencompared with the other embodiments described above, the eighthembodiment of the end effector 8040 is configured such that the rotaryinstrument 8080 and the drive assembly 8082 are formed integrally. Putdifferently, the drive assembly 8082 is not arranged for movementrelative to the actuator 8166 in the eighth embodiment. Furthermore, andas is described in greater detail below, the eighth embodiment of theend effector 8040 is also configured such that the first axis A1 iscoincident with the second axis A2, rather than being different from thesecond axis A2 (e.g., perpendicular) like the embodiments previouslydescribed herein. More specifically, while the eighth embodiment issimilar to the previously-described embodiments in that the first axisA1 is still defined by rotational torque generated by the actuator 8166and the second axis A2 is still defined by rotation of tools 8042secured to the drive assembly 8082, the axes A1, A2 are the same in thisembodiment. Furthermore, when compared to the other embodimentsdescribed above, the eighth embodiment of the end effector 8040 employsa differently-configured trigger assembly 8088, drive assembly 8082,first and second rotational locks RL1, RL2, and axial lock AL whichcooperate to secure tools 8042 in the “top loading” manner through thedrive conduit 8462 in a way that is similar to the fifth, sixth, andseventh embodiments, as described in greater detail below.

Referring now to FIGS. 49A-49B, because the drive assembly 8082 and theactuator 8166 of the rotary instrument 8080 are formed integrally in theeighth embodiment of the end effector 8040 as noted above, theinstrument housing 8168 and the drive body 8250 are realized by the samecomponent (hereinafter referred to as the drive body 8250). The mount8078 is operatively attached to or otherwise formed as a part of thedrive body 8250 and is similarly adapted for releasable attachment tothe coupler 38 of the robotic arm 36 of the surgical robot 32 (see FIG.1). In addition to the mount 8078, the trigger assembly 8088 and aretention mechanism 8664 are also operatively attached to the drive body8250. Furthermore, the drive body 8250 accommodates an actuatorsubassembly 8666 therein (see FIG. 50) which serves as or otherwisedefines the rotary instrument 8080 and its actuator 8166, the reductiongearset 8286, and the drive conduit 8462 in the eighth embodiment of theend effector 8040. As is described in greater detail below in connectionwith FIGS. 56A-59B, the retention mechanism 8664 comprises the guardcover 8350 and is configured to facilitate retention of tools 8042 tothe drive conduit 8462 along the second axis A2.

As is best shown in FIG. 50, the actuator subassembly 8666 generallycomprises a rotor subassembly 8668 and a stator subassembly 8670. Therotor subassembly 8668 is configured to be received distally into thestator subassembly 8670 and is retained in the drive body 8250 via thelower cover 8524. The stator subassembly 8670 is received proximallyinto the drive body 8250 and is retained via an actuator end plate 8672which, in turn, is disposed in threaded engagement with the drive body8250 (see also FIG. 57). The stator subassembly 8670 comprises a stator8674 (depicted generically) and motor sensors 8676 used to, among otherthings, effect commutation of the actuator 8166 which, in therepresentative embodiment illustrated herein, is realized as an inrunnerbrushless direct current electric motor with a rotor 8678 formed as apart of the rotor assembly 8668.

More specifically, and as is best depicted in FIG. 51, the rotorassembly 8668 comprises the rotor 8678, the reduction gearset 8286, andthe drive conduit 8462. Here, the rotor 8678 has a generally tube-shapedprofile and is seated on a perch 8680 formed in the carrier shaft 8422such that the carrier shaft 8422, which also has a generally tube-shapedprofile in this embodiment, extends through the rotor 8678. An actuatorring clamp 8682 secures the rotor 8678 to the carrier shaft 8422 viathreaded engagement, and the carrier shaft 8422 is supported by abearing 8262 disposed in the drive body 8250 such that the rotor 8678and the carrier shaft 8422 of the reduction gearset 8286 rotateconcurrently about the second axis A2 (and also, in this embodiment, thefirst axis A1). In the eighth embodiment, the carrier shaft 8422 alsodefines the second carrier 8298B of the reduction gearset 8286 and, asis described in greater detail below, both the second rotational lockRL2 and the proximal inlet 8480 of the drive bore 8478 of the driveassembly 8082.

Referring now to FIGS. 51 and 57, the drive conduit 8462 extends alongthe second axis A2 between a proximal conduit end 8684 and a distalconduit end 8686, forming part of the drive bore 8478 of the driveassembly 8082 therebetween. The first rotational lock RL1 is realized asa first notch 8688 formed at the proximal conduit end 8684 of the driveconduit 8462, and is configured to rotatably secure certain tools 8042for rotation about the second axis A2 as described in greater detailbelow. The first sun gear 8292A of the reduction gearset 8286 is securedat the distal conduit end 8686 via one or more retention pins 8690 (seeFIGS. 59A-59B) for concurrent rotation with the drive conduit 8462. Thefirst sun gear 8292A is disposed in meshed engagement with the first setof planet gears 8290A which, in turn, are also disposed in meshedengagement with the ring gear 8288. The first set of planet gears 8290Aare supported by the first carrier 8298A which, like the second carrier8298B defined by the carrier shaft 8422, has a generally tube-shapedprofile when coupled to the second sun gear 8292B through which thedrive conduit 8462 extends. Here, the first set of planet gears 8290Aare supported by bearings 8262 which, in turn, are supported by thefirst set of pins 8294A which are coupled to the first carrier 8298A.

The second sun gear 8292B is secured to the first carrier 8298A via oneor more retention pins 8690 (see FIG. 57) and is disposed in meshedengagement with the second set of planet gears 8290B which, in turn, arealso disposed in meshed engagement with the ring gear 8288 and aresupported by the second carrier 8298B defined by the carrier shaft 8422.More specifically, in this embodiment, the carrier shaft 8422 extendsbetween a distal carrier end 8692 and a proximal carrier end 8694, andthe second carrier 8298B of the reduction gearset 8286 is arrangedadjacent to the distal carrier end 8692. Here, the second set of planetgears 8290B are supported by bearings 8262 which, in turn, are supportedby the second set of pins 8294B which are coupled to the second carrier8298B. The second rotational lock RL2 is different from the firstrotational lock RL1, is realized as a second notch 8696 formed at theproximal carrier end 8694 of the carrier shaft 8422, and is configuredto rotatably secure certain tools 8042 for rotation about the secondaxis A2 independent of rotation of the first rotational lock RL1, asdescribed in greater detail below.

In the eighth embodiment of the end effector 8040, the reduction gearset8286 employs a two-stage planetary configuration that affords a torquereduction (and a speed increase) between the second rotational lock RL2defined by the second notch 8696 formed in the carrier shaft 8422 (whichrotates concurrently with the rotor 8678 of the actuator 8166 as notedabove), and the first rotational lock RL1 defined by the first notch8688 formed in the drive conduit 8462 of the drive assembly 8082. Putdifferently, the drive conduit 8462 (and the first rotational lock RL1)rotates at higher speed than the actuator 8166 (and the secondrotational lock RL2) in the eighth embodiment. Furthermore, in theeighth embodiment, rotation of the second rotational lock RL2 about thesecond axis A2 occurs at a ratio of 1:1 with respect to rotation of theactuator 8166 about the first axis A1 (coincident with the second axisA2 in this embodiment). Relative rotation between the drive conduit 8462and the carrier shaft 8422 is facilitated via bearings 8262 supported onthe first carrier 8298A and in the carrier shaft 8422 (see FIG. 57). Asis described in greater detail below, irrespective of whether the tool8042 engages the first rotational lock RL1 to rotate concurrently withthe drive conduit 8462 or the second rotational lock RL2 to rotateconcurrently with the actuator 8166, at least a portion of the tool body8466 extends through the drive conduit 8462 along the second axis A2when the tool 8042 is secured to the end effector 8040.

As noted above, the eighth embodiment of the end effector 8040 isprovided with a differently-configured trigger assembly 8088 and inputtrigger 8092 arranged for engagement by the user to facilitate drivingtools 8042 via rotational torque generated by the actuator 8166. As isbest shown in FIG. 50, the trigger assembly 8088 generally comprises afirst trigger subassembly 8698 and a second trigger subassembly 8700that is operatively attached to the first trigger subassembly 8698 suchas via one or more fasteners (see FIG. 57). More specifically, the firsttrigger subassembly 8698 comprises an upper mount plate 8702, and a gripmount 8704 to which the second trigger subassembly 8698 is attached. Asis described in greater detail below, the retention mechanism 8664 isoperatively attached adjacent to the upper mount plate 8702, and theupper mount plate 8702 also supports a pair of indicator housings,generally indicated at 8706. Moreover, the grip mount 8704 comprises aguard locking subassembly 8708 configured to releasably secure the guardcover 8350 of the retention mechanism 8664, as described in greaterdetail below.

In addition to the actuator end plate 8672, a circuit board 8710 and amid mount plate 8712 are also interposed between the stator subassembly8670 and the upper mount plate 8702 of the first trigger subassembly8698. Here, the actuator end plate 8672 is secured to the drive body8250 via threaded engagement, and the circuit board 8710 is secured tothe actuator end plate 8672 via one or more fasteners. Similarly, themid mount plate 8712 is secured to the drive body 8250 via one or morefasteners, and the upper mount plate 8702 is secured to the mid mountplate 8712 via one or more fasteners. The mid mount plate 8712 supportsvarious seals 8270 and fasteners (e.g., bolts, circlips, and the like),and generally promotes ease of assembly of the end effector 8040.

In the illustrated embodiment, the stator subassembly 8670 comprises anindexing tab 8714 which extends away from the lower cover 8524 andthrough both a plate aperture 8716 formed in the actuator end plate 8672and through a board aperture 8718 formed in the circuit board 8710. Thisconfiguration helps facilitate alignment of the stator assembly 8670relative to the drive body 8250 and the motor sensors 8676 supportedtherein which, in the illustrated embodiment, are disposed in electricalcommunication with a board controller 8720 (depicted schematically;electrical connections not shown) mounted to the circuit board 8710.Here, the board controller 8720 may be utilized to, among other things,communicate with other components of the surgical system 30, facilitatecommutation and/or operation of the actuator 8166, and control variousinputs (e.g., additional sensors) and/or outputs (e.g., indicators) ofthe end effector 8040, as described in greater detail below.

Referring now to FIGS. 52-54, the second trigger subassembly 8700 isoperatively attached to the grip mount 8704 of the first triggersubassembly 8698, such as by one or more fasteners. The second triggersubassembly 8700 generally comprises the grip 8090, the input trigger8092, and the trigger biasing element 8212 which is seated in the inputtrigger 8092 (see FIG. 54). Here in the eighth embodiment of the endeffector 8040, movement of the input trigger 8092 between the first andsecond input positions I1, I2 is determined via a trigger sensor 8722supported in a trigger sensor keeper 8724 secured to the grip 8090 (seeFIGS. 53A-53B), and the input trigger 8092 is retained relative to thegrip 8090 via a pin and slot arrangement (not shown in detail).

The trigger sensor 8722 is disposed in electrical communication withboard controller 8720 mounted on the circuit board 8710 (see FIG. 50;electrical connection not shown) and is responsive to movement of firstand second trigger emitters 8726, 8728 coupled to the input trigger 8092for concurrent movement between the first and second input positions I1,I2 (see FIG. 54). To this end, the input trigger 8092 is configured suchthat the first trigger emitter 8726 is arranged adjacent to the triggersensor 8722 when in the first input position I1 and the second trigger8728 is arranged adjacent to the trigger sensor 8722 when in the secondinput position I2. The trigger sensor keeper 8724 also supports an inputbutton 8730, which is likewise disposed in electrical communication withthe board controller 8720 (see FIG. 50; electrical connection not shown)and is arranged for engagement by the user. The input button 8730 isseated within a cover aperture 8732 formed in a grip cover 8734 securedto the grip 8090 via a fastener, and is arranged for engagement by theuser to facilitate additional control of the surgical system 30. It willbe appreciated that the input button 8730 could be configured tofacilitate control over a number of different aspects of the endeffector 8040 (e.g., switching into haptic mode). Other configurationsare contemplated.

In addition to the input trigger 8092 and the input button 8730, thesecond trigger subassembly 8700 also comprises an input switch 8736which is supported by a switch shaft 8738 for pivoting movement relativeto the grip 8090 between left and right switch positions (not shown indetail) via engagement by the user. Here, a switch sensor 8740 disposedin electrical communication with the board controller 8720 is seated inthe grip 8090 (see FIG. 50; electrical connection not shown). The switchsensor 8740 is responsive to movement of a switch emitter 8742 coupledto the input switch 8736 for concurrent movement relative to the grip8090. In the illustrated embodiment, a switch detent arrangement,generally indicated at 8744, is provided to keep the input switch 8736in one of the left and right switch positions during an absence ofengagement from the user. While not illustrated in detail, the switchemitter 8742 is disposed adjacent to the switch sensor 8740 in one ofthe left and right switch positions maintained by the switch detentarrangement 8744 and is spaced from the switch sensor 8740 in the otherof the left and right switch positions such that the board controller8720 can differentiate therebetween. Like the input button 8730described above, movement of the input switch 8736 can be utilized tofacilitate additional control of the surgical system 30. By way ofnon-limiting example, movement of the input switch 8736 between the leftand right switch positions described above could correspond to operationof the actuator 8166 in respective “forward” and “reverse” directionsto, for example, rotate the tool 8042 about the second axis A2 inclockwise and counterclockwise directions. Other configurations arecontemplated.

Referring now to FIGS. 55-57, the first trigger subassembly 8698 isconfigured to facilitate releasably securing the guard cover 8350 of theretention mechanism 8664 in the first guard position U1 which, in theeighth embodiment, ensures that the tool 8042 is retained both rotatablyby one of the first and second rotational locks RL1, RL2 and alsoaxially by the axial lock AL. Here, and as will be appreciated from thesubsequent description of the retention mechanism 8664 below, the firstguard position U1 also defines operation of the axial lock AL in thelock configuration ACL and, unlike the second embodiment of the endeffector 2040 described above, promotes access to the manual interface8094.

In order to maintain operation axial lock AL in the lock configurationACL, the guard locking subassembly 8708 of the first trigger subassembly8698 selectively inhibits movement of the guard cover 8350 of theretention mechanism 8664 relative to the grip mount 8704. To this end,and as is best depicted in FIG. 55, the guard locking subassembly 8708comprises a guard lever 8746 supported for pivoting movement relative tothe grip mount 8704 via a lever fastener shank 8748 defined by afastener securing a keeper mount 8750 to the grip mount 8704. The guardlever 8746 is arranged between a pair of washers 8214 supported on thelever fastener shank 8748, and comprises a lever pawl 8752 which isdisposed in engagement with a pawl stop member 8754 of the retentionmechanism 8664 via a lever biasing element 8756, as described in greaterdetail below. The keeper mount 8750 also supports a lever sensor 8758which is responsive to movement of a lever emitter 8760 coupled to theguard lever 8746 for concurrent movement between the lock configurationACL and the release configuration ACR. The guard locking subassembly8708 also comprises an upper vertical stop 8762 coupled to the keepermount 8750, and a lower vertical stop 8764 and a lateral stop 8766 eachcoupled to the grip mount 8704. As is described in greater detail below,in the lock configuration ACL, the pawl stop member 8754 is disposed inengagement between the lever pawl 8752 and the lateral stop 8766, andthe upper vertical stop 8762 and the lower vertical stop 8764respectively engage an upper vertical member 8768 and a lower verticalmember 8770 each coupled to the retention mechanism 8664 (see FIG. 56C).

With continued reference to FIG. 55, the guard locking subassembly 8708of the first trigger subassembly 8698 also comprises a guard sensor 8772supported in the grip mount 8704 adjacent to the lower vertical stop8764. The guard sensor 8772 is responsive to changes in the position ofa guard emitter 8774 (see FIGS. 56B and 56D) coupled to the retentionmechanism 8664. Both the guard sensor 8772 and the lever sensor 8758 aredisposed in electrical communication with the board controller 8720 (seeFIG. 50; electrical connection not shown), and cooperate to determineoperation of the axial lock AL between the lock configuration ACL andthe release configuration ACR, as described in greater detail below.Furthermore, the indicator housings 8706 coupled to the upper mountplate 8702 of the first trigger subassembly 8698 each comprise a pair ofindicator modules 8776 (e.g., light emitting diodes) that are similarlydisposed in electrical communication with the board controller 8720 (seeFIG. 50; electrical connection not shown), and may be employed toprovide the user with visual feedback by changing color, state,brightness, and the like, in response to various corresponding orotherwise predetermined configurations or operational parameters ofand/or associated with the end effector 8040. By way of non-limitingexample, the indicator modules 8776 could emit red-colored light whenthe axial lock AL is in the release configuration ACR, and could emitgreen-colored light when the axial lock AL is in the lock configurationACL. Other configurations are contemplated.

It will be appreciated that electrical communication between the variouselectrical components operatively attached to the first and secondtrigger subassemblies 8698, 8700 and the board controller 8720 and/orother components mounted on the circuit board 8710 can be facilitated ina number of different ways, including without limitation wiredconnections, wireless communication, and the like. Furthermore, whilethe trigger assembly 8088 is not generally arranged for movementrelative to the drive body 8250 in the eighth embodiment of the endeffector 8040, it will be appreciated that all or a portion of thetrigger assembly 8088 could be configured to move or to otherwise beselectively positioned by the user in some embodiments. By way ofnon-limiting example, all or a portion of the grip 8090 may be movable(e.g., rotatable) such that one or more sensors, buttons, and the likemove concurrently with the grip 8090 relative to the circuit board 8710and/or the drive body 8250. In such embodiments, electricalcommunication may be facilitated such as is described in U.S.Provisional Patent Application No. 62/678,838, filed on May 31, 2018,entitled “Rotating Switch Sensor for a Robotic System,” the disclosureof which is hereby incorporated by reference in its entirety. Otherconfigurations are contemplated.

Referring now to FIG. 49B, two types of tools 8042 are shown configuredfor “top loading” attachment to the drive conduit 8462 of the endeffector 8040: the rotary cutting tool 8044 and the rotary driving tool8048 with the anchor 8050. Here, the tools 8042 each comprise a bearingelement 8778 formed on the tool body 8466 between the interface end 8468and the working end 8470. The bearing element 8778 is shaped andarranged to engage a bearing 8262 that defines a portion of the drivebore 8478 defined adjacent to the distal outlet 8482 (see FIG. 59B).This configuration helps promote alignment of the tool 8042 for rotationabout the second axis A2. Each of the tools 8042 also comprises aproximal key body 8780 arranged at the interface end 8468 of the toolbody 8466. The proximal key body 8780 for each of the representativetools 8042 illustrated in FIG. 49B are different from one another, buteach defines a proximal key face 8782 that is substantiallyperpendicular to the second axis A2. A proximal key element 8784, whichhas a cylindrical outer profile, extends from the proximal key face 8782in a direction facing away from the working end 8470 of the tool body8466. The proximal key face 8782 and the proximal key element 8784cooperate with the retention mechanism 8664 to facilitate operation ofthe axial lock AL, as described in greater detail below.

In the eight embodiment, each of the illustrated types of tools 8042 hasa differently-configured conduit rotational retainer 8464 interposedbetween the proximal key element 8784 and the bearing element 8778. Morespecifically, the rotary cutting tool 8044 comprises a first seatelement 8786 with a first notch element 8788 and a first seat flange8790 that defines a first seat face 8792, and the rotary driving tool8048 comprises a second seat element 8794 with a second notch element8796 and a second seat flange 8798 that defines a second seat face 8800.The first seat element 8786 is shaped and arranged so as to be disposedwithin the drive conduit 8462, with the first notch element 8788disposed in the first notch 8688 and with the first seat face 8792abutting the proximal conduit end 8684 of the drive conduit 8462 todefine the first rotational lock RL1 (see FIGS. 58A-58D). The secondseat element 8794, in turn, is shaped and arranged so as to be disposedwithin the carrier shaft 8422, with the second notch element 8796disposed in the second notch 8696 and with the second seat face 8800abutting the proximal carrier end 8694 of the carrier shaft 8422 todefine the second rotational lock RL2 (see FIGS. 63A-63E; not shown indetail).

Referring now to FIGS. 56A-57, the retention mechanism 8664 defines theaxial lock AL and comprises the guard cover 8350 in the eighthembodiment of the end effector 8040, as noted above. Here, the guardcover 8350 is similarly movable from the first guard position U1 (seeFIGS. 56A-56D) to the second guard position U2 (see FIG. 57) tofacilitate “top loading” insertion and removal of tools 8042 from thedrive conduit 8462. Furthermore, the axial lock AL can be moved into andout of engagement with the guard locking subassembly 8708 between thelock configuration ACL (see FIGS. 56A-56B) and the release configurationACR (see FIGS. 56C-56D). Here in the eighth embodiment of the endeffector 8040, the guard cover 8350 needs to be arranged in the firstguard position U1 before the axial lock AL can be moved to the lockconfiguration ACL, which simultaneously restricts relative movementbetween the secured tool 8042 and the drive conduit 8462 via theretention mechanism 8664, and also between the guard cover 8350 and thedrive body 8250 via the guard locking subassembly 8708. To this end, andas is best depicted in FIGS. 56B and 57, the guard body 8352 of theguard cover 8350 comprises knob guideslots 8802 along which knobretainers 8804 coupled to a guard knob 8806 ride. The knob retainers8804 support bearings 8262 thereon, and travel along the knob guideslots8802 as the guard knob 8806 is rotated to facilitate operation of theaxial lock AL, as described in greater detail below.

The guard knob 8806 is prevented from detaching from the guard body 8352via one or more fasteners (e.g., rings, circlips, and the like) and aknob keeper 8808 that supports a guard knob biasing element 8810disposed in engagement with the guard knob 8806 to urge the guard knob8806 away from the guard body 8352. This configuration provides the userwith haptic feedback when engaging the guard knob 8806 to move the axiallock AL from the lock configuration ACL (see FIGS. 56A-56B and 58D) tothe release configuration ACR (see FIGS. 56C-56D and 58C), and alsoresults in compressing the guard knob biasing element 8810 when the userrotates the guard knob 8806 to move from the release configuration ACRto the lock configuration ACL as the knob retainers 8804 ride along theknob guideslots 8802.

Referring now to FIGS. 56A-58D, the retention mechanism 8664 alsocomprises a key hub 8812 and a key collar 8814 that are operativelyattached to the guard knob 8806. A bearing 8262 rotatably supports thekey hub 8812 for rotation relative to the guard knob 8806, and a keythrust bearing 8816 helps prevent binding between the key hub 8812 andthe guard knob 8806 as the axial lock AL moves between the releaseconfiguration ACR and the lock configuration ACL. The key collar 8814comprises key collar slots 8818 in which key pins 8820 coupled to thekey hub 8812 are arranged for movement. This configuration facilitateslimited movement of the key collar 8814 relative to the key hub 8812while also retaining the key collar 8814. A key collar biasing element8822 interposed between the key hub 8812 and the key collar 8814 urgesthe key collar 8814 generally away from the key hub 8812. When one ofthe tools 8042 has been inserted through the drive conduit 8462 and whenthe guard cover 8350 has been moved to the first guard position U1 asdepicted in FIG. 58C, both the key hub 8812 and the key collar 8814 arespaced away from the proximal key element 8784 of the tool 8042. Here,the key collar 8814 is disposed closer to the proximal key element 8784than the key hub 8812 until rotation of the guard knob 8806 brings thekey collar 8814 into abutment with the proximal key face 8782 of thetool body 8466 as the axial lock AL moves toward the lock configurationACL which, in turn, compresses the key collar biasing element 8822. Asshown in FIG. 58D, the key hub 8812 is shaped to receive the proximalkey element 8784 of the tool 8042 therein when in the lock configurationACL, with portions of both the key hub 8812 and the key collar 8814disposed in abutment with the proximal key face 8782. This configurationhelps guide the proximal key element 8784 into the key hub 8812 which,in turn, helps facilitate alignment of the tool 8042 about the secondaxis A2.

The key collar 8814 and the key hub 8812 each have a generallycylindrical inner profile which are disposed in communication with thedrive bore 8478 adjacent to the proximal inlet 8480 when the guard cover8350 is in the first guard position U1. Furthermore, the guard cover8350 is provided with a generally cylindrical knob aperture 8824 that isdisposed in communication with the inner profiles of the key collar 8814and the key hub 8812. This configuration provides the user with theability to access the manual interface 8094 through the knob aperture8824 which, in the eighth embodiment of the end effector 8040, isrealized as a part of the rotary driving tool 8048 described in greaterdetail below in connection with FIGS. 60-62B.

As is best depicted in FIG. 56C, the lower vertical member 8770 iscoupled to the guard body 8352 and abuts the lower vertical stop 8764coupled to the grip mount 8704 when the guard cover 8350 is in the firstguard position U1. The upper vertical member 8768, the pawl stop member8754, and the guard emitter 8774 (see FIG. 56D) are each coupled to theguard knob 8806 for concurrent movement relative to the guard body 8352.When the guard knob 8806 is rotated to bring the axial lock AL from therelease configuration ACR depicted in FIGS. 56C-56D to the lockconfiguration ACL depicted in FIGS. 56A-56B, the pawl stop member 8754first comes into contact with the lever pawl 8752 of the guard lever8746 which pivots the guard lever 8746 until continued rotation of theguard knob 8806 brings the pawl stop member 8754 into abutment with thelateral stop 8766. Here in the lock configuration ACL depicted in FIGS.56A-56B, the lever biasing element 8756 urges the guard lever 8746against the pawl stop member 8754 which, in turn, is also disposed inabutment with the lateral stop 8766. Here too, the upper vertical member8768 comes into abutment with the upper vertical stop 8762. As such, inthe lock configuration ACL, movement of the guard knob 8806 relative tothe guard body 8352 and the grip mount 8704 is inhibited until the userengages the guard lever 8746 to release the pawl stop member 8754. Asnoted above, the guard sensor 8772 coupled to the grip mount 8704 isresponsive to movement of the guard emitter 8774 coupled to the guardknob 8806 such that the board controller 8720 can determine movement ofthe axial lock AL between the lock configuration ACL and the releaseconfiguration ACR. Similarly, the lever sensor 8758 coupled to the gripmount 8704 is responsive to movement of the lever emitter 8760 coupledto the guard lever 8746 such that the board controller 8720 candetermine movement of the guard lever 8746.

Referring now to FIGS. 60-62B, as noted above, the illustrated rotarydriving tool 8048 is adapted for releasable attachment to the eighthembodiment of the end effector 8040 in the “top loading” manner and, inturn, is configured to releasably attach to the anchor 8050 using adifferently-configured locking subassembly 8810 when compared to therotary driving tool 48 described above in connection with the firstembodiment of the end effector 40. Here in the eighth embodiment, and asis best depicted in FIG. 60, the support tube 8106 generally defines thetool body 8466 and extends between the external threads 8120 adjacent tothe working end 8470 and the contoured body 8108 adjacent to theinterface end 8468, with the bearing element 8778 arranged therebetween.The driveshaft 8104, which is similarly arranged so as to be rotatablysupported within the support tube 8106, extends between the driver key8124 adjacent to the working end 8470 and a hex portion 8826 adjacent tothe interface end 8468. Lock element detents 8828 formed in the hexportion 8826 are shaped to receive driveshaft lock elements 8830 inorder to facilitate concurrent rotation of the driveshaft 8104 and thesupport tube 8106 under certain conditions described in greater detailbelow.

The second seat element 8794 is formed as a separate component from thesupport tube 8106 and is disposed adjacent to the contoured body 8108.Here, a pair of fasteners secure the second seat element 8794 to acarriage 8832 for concurrent translation and rotation about the secondaxis A2. The carriage 8832 generally comprises a carriage ring 8834which generally secures to the second seat element 8794, a carriagebridge 8836, and a pair of carriage arms 8838 which extend between andmerge with the carriage ring 8834 and the carriage bridge 8836. Thecarriage bridge 8836 defines a first carriage face 8840 and an opposingsecond carriage face 8842. Here, the proximal key body 8780 and theproximal key element 8784 extend from the first carriage face 8840 suchthat the proximal key face 8782 is spaced from and substantiallyparallel to the first carriage face 8840. A carriage pilot 8844 extendsfrom the second carriage face 8842 toward the carriage ring 8834, andcomprises a pair of lock element pockets 8846 which are shaped tosupport the driveshaft lock elements 8830 therein. The carriage pilot8844 also comprises a hex bore 8848 extending therethrough (and out ofthe proximal key element 8784) which is shaped to receive the hexportion 8826 of the driveshaft 8104. Here too in the eighth embodiment,the hex bore 8848 also serves as the manual interface 8094 and isaccessible along the second axis A2 through the knob aperture 8824 (seeFIG. 58D). While not illustrated in this embodiment, it will beappreciated that the manual interface 8094 could be engaged via acorrespondingly-shaped handle assembly to rotate the carriage 8832 aboutthe second axis A2.

With continued reference to FIGS. 60-62B, the locking subassembly 8810of the rotary driving tool 8048 also comprises the locking body 8114,which is arranged between the contoured body 8108 and the carriage 8832and can rotate concurrently with the support tube 8106 via the splinedengagement 8112 with the contoured body 8108 when the lockingsubassembly 8810 operates in a driver locked configuration DL (see FIGS.61A and 62A). However, the support tube 8106 can be rotatedindependently of the driveshaft 8104 when the locking subassembly 8810operates in a driver unlocked configuration DU where the splinedengagement 8112 is interrupted between the contoured body 8108 and thelocking body 8114 (see FIGS. 61B and 62B). Here, a locking body biasingelement 8850 supported by a locking seat 8852 formed on the locking body8114 is disposed within the contoured body 8108 and urges the lockingsubassembly 8810 toward the driver unlocked configuration DU.

The locking body 8114 also comprises a relief pocket 8854 disposed inthe locking seat 8852 axially-adjacent to the splined engagement 8112(see FIGS. 61A-62B), and a bridge notch 8856 which is shaped to receivethe carriage bridge 8836 of the carriage 8832 therein such that relativerotation between the carriage 8832 and the locking body 8114 isinhibited in both the driver locked configuration DL and the driverunlocked configuration DU. The relief pocket 8854 is formed inside inthe locking body 8114 and is arranged to accommodate the driveshaft lockelements 8830 when the locking subassembly 8810 is in the driver lockedconfiguration DL (see FIG. 62A). This configuration permits thedriveshaft 8104 to be advanced along the second axis A2 relative to thecarriage 8832, such as to facilitate attachment of the anchor 8050 priorto loading the tool 8042 into the drive conduit 8462. Conversely, whenin the driver unlocked configuration DU (see FIG. 62B), the driveshaftlock elements 8830 are spaced from the relief pocket 8854 and aredisposed generally within the locking seat 8852 to inhibit axialmovement of the driveshaft 8104 relative to the carriage 8832. Thisconfiguration also permits the support tube 8106 to be rotated relativeto the driveshaft 8104, such as to facilitate removal of the anchor 8050by disengaging the external threads 8120 of the support tube 8106 fromthe internal threads 8122 of the anchor 8050.

In order to selectively maintain the locking subassembly 8110 in eitherthe driver locked configuration DL or the driver unlocked configurationDU, the locking subassembly 8810 also comprises a carriage lock lever8858 that is seated within a stepped region 8860 of the locking body8114. The carriage lock lever 8858 is supported for pivoting movementrelative to the locking body 8114 via the pin 8119, is biased via thespring 8118, and defines a first lever face 8862 and an opposing secondlever face 8864. Here, the first lever face 8862 abuts the firstcarriage face 8840 in the driver unlocked configuration DU (see FIG.61B), and the second lever face 8864 abuts the second carriage face 8842in the driver locked configuration DL (see FIG. 61A; not shown indetail). Here, the user can engage the carriage lock lever 8858 andpivot it about the pin 8119 into the stepped region 8860 of the lockingbody 8114 to permit the locking body 8114 to move along the second axisA2 relative to the carriage 8832 in an absence of abutment between thefirst lever face 8862 and the first carriage face 8840 or between thesecond lever face 8864 and the second carriage face 8842.

Referring now to FIGS. 63A-63F, certain exemplary steps of utilizing therotary driving tool 8048 to secure the anchor 8050 at the surgical siteST with the eighth embodiment of the end effector 8040 are shownsequentially. Beginning with FIG. 63A, the schematically-depictedsurgical site ST is shown with the pilot hole 8046 already formed alongthe trajectory T. The rotary driving tool 8048 is shown secured to theanchor 8050 and spaced from the end effector 8040. Here, the guard cover8350 of the retention mechanism 8664 is positioned in the second guardposition U2 to expose the proximal inlet 8480 of the drive bore 8478 ofthe drive assembly 8082.

In FIG. 63B, the user has loaded the tool 8042 into the drive conduit8462 in the “top loading” manner by inserting the working end 8470 ofthe tool 8042 (defined here by the distal tip 8050D of the anchor 8050)into the proximal inlet 8480 of the drive bore 8478 and advanced alongthe second axis A2 through the drive conduit 8462 and out of the distaloutlet 8482 of the drive bore 8478 toward the surgical site ST. Theaxial lock AL defined by the retention mechanism 8664 remains in therelease configuration ACR while the guard cover 8350 is arranged in thesecond guard position U2, which permits the tool 8042 to be freelyremoved from the drive conduit 8462 along the second axis A2 in adirection facing away from the surgical site ST. However, furthermovement along the second axis A2 relative to the drive conduit 8462toward the surgical site ST is inhibited by the engagement betweensecond seat element 8794 of the tool body 8466 and the proximal carrierend 8694 of the carrier shaft 8422. Here too, engagement of the secondnotch element 8796 of the rotary driving tool 8048 with the second notch8696 of the carrier shaft 8422 (see FIGS. 51 and 57) defines the secondrotational lock RL2 such that the rotary driving tool 8048 and thecarrier shaft 8422 rotate concurrently about the second axis A2.

In FIG. 63C, the guard cover 8350 of the retention mechanism 8664 hasbeen pivoted to the first guard position U1, and the guard knob 8806 hasbeen rotated to move the axial lock AL from the release configurationACR (see FIG. 58C) to the lock configuration ACL (see FIG. 58D). Here,relative movement between the drive assembly 8082 and the rotary drivingtool 8048 is restricted along the second axis A2, and the user can drivethe tool 8042 via the trigger assembly 8088 to advance the anchor 8050along the trajectory T into the pilot hole 8046 of the surgical site STusing the actuator 8166 of the rotary instrument 8080. Here too, theuser can also apply force to the manual interface 8094 to drive the tool8042 along the trajectory T without the actuator 8166, such as with ahandle assembly inserted through the knob aperture 8824 and into the hexbore 8848 of the rotary driving tool 8048 (see FIGS. 61A-62B).

In FIG. 63D, the user has completed installation of the anchor 8050 atthe surgical site ST along the trajectory T. Here, the guard cover 8350of the retention mechanism 8664 has been moved back to the second guardposition U2 and the axial lock AL is in the release configuration ACR.Moreover, the locking subassembly 8810 of the rotary driving tool 8048is arranged in the driver locked configuration DL. However, in FIG. 63E,the locking subassembly 8810 has been moved to the driver unlockedconfiguration DU such that the rotary driving tool 8048 can be releasedfrom the anchor 8050 and subsequently removed from the drive conduit8462 of the end effector 8040, as shown in FIG. 63F.

Referring again to FIG. 63D, in order to release the anchor 8050 fromthe rotary driving tool 8084 after the user has completed installationof the anchor 8050 at the surgical site ST along the trajectory T, theactuator 8166 (or another component of the end effector 8050) may beplaced into a mode which restricts or otherwise prevents rotation of thedrive conduit 8462 in both directions (e.g., by driving the actuator8166 to maintain a position without rotating) or in a single direction(e.g., by driving the actuator 8166 to prevent rotation in a directionthat is opposite to the rotational direction used to install the anchor8050). To this end, it will be appreciated that the actuator 8166 itselfcould be driven in various ways, and that additional components and/orlocking features could be employed to, for example, inhibit or otherwiselimit rotation of the drive conduit 8462 relative to the drive body 8250or another portion of the end effector 8040. Here, inhibiting rotationof the drive conduit 8462 also inhibits rotation of the second seatelement 8794 via the second rotational lock RL2. Thus, when the lockingsubassembly 8810 is in the driver unlocked configuration DU as depictedin FIG. 63E, the support tube 8106 can be rotated (and translatedaxially) relative to the driveshaft 8104 (and, thus, to the anchor 8050)in order to disengage the external threads 8120 of the support tube 8106from the internal threads 8122 of the anchor 8050 (see FIG. 60) andthereby facilitate removal of the anchor 8050 as shown in FIG. 63F.

The embodiments of the surgical systems 30, end effectors, and methodsdescribed herein afford advantages in connection with a broad number ofmedical and/or surgical procedures including, for example, wheresurgical robots 32 are utilized in minimally-invasive surgicalprocedures such as spinal fusions. Specifically, it will be appreciatedthat the embodiments of the end effector described and illustratedherein are configured to facilitate rotation of different types of toolsalong the second axis A2 via rotation from the actuator of the rotaryinstrument about the first axis A1, which may be the same as the secondaxis A2 or may be different from the second axis A2 as noted above.Moreover, it will be appreciated that the manual interface affordssurgeons with the ability to rotate tools about the second axis A2 viatorque generated by the actuator of the rotary instrument and/or viamanual application of force to the handle assembly. Furthermore, thearrangement of the trigger assembly allows the surgeon to apply force tothe end effector to advance the tool along the trajectory T in-line withthe second axis A2 while simultaneously engaging the input trigger todrive the rotary instrument, while also affording the surgeon withunobstructed access to the manual interface after moving to the secondtrigger assembly position P2 or otherwise presenting the manualinterface.

Those having ordinary skill in the art will appreciate that aspects ofthe embodiments described and illustrated herein can be interchanged orotherwise combined.

It will be further appreciated that the terms “include,” “includes,” and“including” have the same meaning as the terms “comprise,” “comprises,”and “comprising.” Moreover, it will be appreciated that terms such as“first,” “second,” “third,” and the like are used herein todifferentiate certain structural features and components for thenon-limiting, illustrative purposes of clarity and consistency.

Several configurations have been discussed in the foregoing description.However, the configurations discussed herein are not intended to beexhaustive or limit the invention to any particular form. Theterminology which has been used is intended to be in the nature of wordsof description rather than of limitation. Many modifications andvariations are possible in light of the above teachings and theinvention may be practiced otherwise than as specifically described.

What is claimed is:
 1. An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having an interface end and a working end, said end effector comprising: a mount adapted to attach to the surgical robot; an actuator coupled to said mount and configured to generate rotational torque about a first axis; and a drive assembly comprising: a geartrain to translate rotation from said actuator about said first axis into rotation about a second axis, a drive conduit supported for rotation about said second axis, said drive conduit defining a drive bore shaped for receiving the working end of the tool along said second axis, a first rotational lock operatively attached to said drive conduit to releasably secure the tool for concurrent rotation about said second axis, and an axial lock to releasably secure the tool for concurrent translation with said drive conduit along the trajectory maintained by the surgical robot, said axial lock being operable between: a release configuration wherein relative movement between said drive assembly and the tool is permitted along said second axis, and a lock configuration wherein relative movement between said drive assembly and the tool is restricted along said second axis wherein said drive assembly defines a proximal inlet and an opposing distal outlet, with said drive conduit interposed in communication between said proximal inlet and said distal outlet for permitting the working end of the tool to be inserted along said second axis into said proximal inlet and advanced through said drive bore and out of said distal outlet toward the surgical site when said axial lock is in said release configuration.
 2. The end effector as set forth in claim 1, wherein at least a portion of said drive bore of said drive conduit defines said first rotational lock.
 3. The end effector as set forth in claim 2, wherein said first rotational lock of said drive assembly is shaped to engage at least a portion of the tool between the interface end and the working end when said axial lock is in said lock configuration such that the interface end of the tool is arranged proximal to said drive bore and the working end of the tool is arranged distal to said drive bore.
 4. The end effector as set forth in claim 1, wherein said geartrain of said drive assembly comprises at least one reduction gearset interposed in rotational communication between said actuator and said drive conduit such that rotation of said actuator about said first axis occurs at a different speed than rotation of said first rotational lock about said second axis.
 5. The end effector as set forth in claim 4, wherein said drive assembly further comprises a second rotational lock, different from said first rotational lock, operatively attached to said drive conduit to releasably secure a second tool for concurrent rotation about said second axis, with said second rotational lock disposed in rotational communication with said geartrain such that rotation of said second rotational lock about said second axis occurs at a different speed than rotation of said first rotational lock about said second axis.
 6. The end effector as set forth in claim 5, wherein rotation of said second rotational lock about said second axis occurs at a ratio of 1:1 with respect to rotation of said actuator about said first axis.
 7. The end effector as set forth in claim 1, wherein said geartrain of said drive assembly comprises a transmission interposed in rotational communication between said actuator and said drive conduit, said transmission comprising a first gearset, a second gearset, and a shift collar arranged for movement between: a first collar position where said shift collar engages said first gearset to translate rotation between said actuator and said drive conduit at a first drive ratio, and a second collar position where said shift collar engages said second gearset to translate rotation between said actuator and said drive conduit at a second drive ratio different from said first drive ratio.
 8. The end effector as set forth in claim 7, wherein said transmission further comprises a transmission linkage operatively attached to said shift collar for concurrent movement between said first collar position and said second collar position, said transmission linkage defining a selector arranged to engage at least a portion of the tool to move said shift collar to said second collar position when said axial lock is in said lock configuration.
 9. The end effector as set forth in claim 1, wherein said first rotational lock comprises one or more of a keyed bore, a splined bore, and a notch.
 10. The end effector as set forth in claim 1, wherein said axial lock comprises a slider element arranged for movement relative to said second axis between: a first slider element position associated with said release configuration; and a second slider element position associated with said lock configuration.
 11. The end effector as set forth in claim 1, wherein said axial lock comprises a collet mechanism comprising: a collet arranged to receive the tool therethrough along said second axis; and a collet tensioner coupled to said collet and arranged for movement between a first tensioner position associated with said release configuration where relative movement is permitted between the tool and said collet, and a second tensioner position associated with said lock configuration where relative movement is restricted between the tool and said collet.
 12. The end effector as set forth in claim 1, further comprising a light source operatively attached to said mount and configured to emit light toward the surgical site.
 13. The end effector as set forth in claim 12, wherein the light source is configured for removable attachment to said drive conduit of said drive assembly.
 14. An end effector for guiding tools relative to a surgical site along a trajectory maintained by a surgical robot, the tools including a first tool and a second tool different from the first tool, said end effector comprising: a mount adapted to attach to the surgical robot; a rotary instrument coupled to said mount and comprising an actuator configured to generate rotational torque about a first axis; and a drive assembly comprising a geartrain to translate rotation from said rotary instrument about said first axis into rotation about a second axis, a first rotational lock disposed in rotational communication with said geartrain to releasably secure the first tool for concurrent rotation about said second axis at a first drive ratio, a second rotational lock disposed in communication with said geartrain to releasably secure the second tool for concurrent rotation about said second axis at a second drive ratio different from said first drive ratio, and an axial lock to releasably secure one of the first tool and the second tool for concurrent translation with said drive assembly along the trajectory maintained by the surgical robot, said axial lock being operable between: a release configuration wherein relative movement between said drive assembly and the secured tool is permitted along said second axis, and a lock configuration wherein relative movement between said drive assembly and the secured tool is restricted along said second axis.
 15. An end effector for driving tools at a surgical site along a trajectory maintained by a surgical robot, the tools including a first tool and a second tool different from the first tool, said end effector comprising: a mount adapted to attach to the surgical robot; a rotary instrument coupled to said mount and comprising an actuator configured to generate rotational torque about a first axis; and a drive assembly comprising a geartrain to translate rotation from said rotary instrument into rotation about a second axis different from said first axis, a connector configured to releasably secure one of the first tool and the second tool for rotation about said second axis, and a transmission interposed in rotational communication between said rotary instrument and said connector, said transmission comprising a first gearset, a second gearset, and a shift collar arranged for movement between: a first collar position where said shift collar engages said first gearset to translate rotation between said rotary instrument and said connector at a first drive ratio, and a second collar position where said shift collar engages at said second gearset to translate rotation between said rotary instrument and said connector at a second drive ratio different from said first drive ratio.
 16. An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, said end effector comprising: a mount adapted to attach to the surgical robot; a rotary instrument coupled to said mount and comprising an actuator configured to generate rotational torque about a first axis; a drive assembly comprising a geartrain to translate rotation from said rotary instrument into rotation about a second axis different from said first axis, and a connector configured to releasably secure the tool for rotation about said second axis; a trigger assembly comprising a grip to support a user's hand, and an input trigger in communication with said rotary instrument and arranged for engagement by the user to drive said rotary instrument and rotate the tool about said second axis; and a manual interface to communicate with said drive assembly and arranged to receive and translate applied force from the user into rotational torque to rotate the tool about said second axis.
 17. The end effector as set forth in claim 16, wherein said trigger assembly comprises a frame supporting said grip and said input trigger for movement relative to said rotary instrument between a plurality of trigger assembly positions, said frame comprising: a first frame body arranged for movement relative to said rotary instrument between said plurality of trigger assembly positions; and a second frame body supporting said grip and said input trigger for movement relative to said first frame body between a plurality of grip positions.
 18. The end effector as set forth in claim 17, wherein said plurality of grip positions include: a first grip position where at least a portion of said second frame body limits access to said manual interface, and where said input trigger is arranged for engagement by the user to drive said rotary instrument to rotate the tool about said second axis; and a second grip position where said second frame body is disposed in spaced relation to said manual interface to facilitate receiving applied force from the user to rotate the tool about said second axis.
 19. The end effector as set forth in claim 17, wherein said plurality of trigger assembly positions include: a first trigger assembly position where said trigger assembly is arranged for engagement by the user to drive said rotary instrument to rotate the tool about said second axis; and a second trigger assembly position where said manual interface is arranged to receive applied force from the user to rotate the tool about said second axis.
 20. The end effector as set forth in claim 19, wherein said grip of said trigger assembly is substantially parallel to said second axis when said trigger assembly is in one of said first and second trigger assembly positions.
 21. The end effector as set forth in claim 19, wherein said grip of said trigger assembly is substantially perpendicular to said second axis when said trigger assembly is in one of said first and second trigger assembly positions.
 22. The end effector as set forth in claim 21, wherein said grip of said trigger assembly is substantially parallel to said second axis when said trigger assembly is in the other of said first and second trigger assembly positions.
 23. The end effector as set forth in claim 16, wherein said manual interface comprises a head arranged for rotation about said second axis to received applied rotational force from the user; and further comprising a guard cover operatively attached to said drive assembly and arranged for movement relative to said second axis between: a first guard position wherein said second axis intersects at least a portion of said guard cover to limit access to said manual interface; and a second guard position wherein said guard cover is spaced from said second axis to promote access to said manual interface.
 24. The end effector as set forth in claim 16, further comprising a handle assembly to attach to said manual interface such that force applied to said handle assembly rotates the tool about said second axis.
 25. The end effector as set forth in claim 24, wherein said manual interface comprises a head arranged for rotation about said second axis; and wherein said handle assembly comprises a driver shaped to receive said head of said manual interface for concurrent rotation in response to force applied to said handle assembly by the user.
 26. The end effector as set forth in claim 25, further comprising a differential assembly interposed between said rotary instrument, said connector, and said manual interface, said differential assembly being operable between: a haptic mode where rotational torque generated by said rotary instrument translates through said differential assembly to said connector to rotate the tool about said second axis and also translates to said head of said manual interface to provide tactile torque feedback at said manual interface; a first interrupt mode where rotational torque generated by said rotary instrument translates through said differential assembly to said connector to rotate the tool about said second axis without translating rotational torque to said head of said manual interface; and a second interrupt mode where rotational torque applied to said head of said manual interface translates through said differential assembly to said connector to rotate the tool about said second axis without translating rotational torque to said rotary instrument.
 27. The end effector as set forth in claim 16, wherein said geartrain of said drive assembly comprises at least one reduction gearset interposed in rotational communication between said rotary instrument and said connector such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 28. The end effector as set forth in claim 16, wherein said geartrain of said drive assembly comprises at least one bevel gearset interposed in rotational communication between said rotary instrument and said connector to translate rotation about said first axis into rotation about said second axis.
 29. The end effector as set forth in claim 28, wherein said bevel gearset comprises a reduction gearset configured such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 30. An end effector for driving a tool at a surgical site along different trajectories selectively maintained by a surgical robot, said end effector comprising: a mount adapted to attach to the surgical robot; a rotary instrument coupled to said mount and comprising an actuator configured to generate rotational torque about a first axis; a drive assembly comprising a geartrain to translate rotation from said rotary instrument into rotation about a second axis different from said first axis, and a connector configured to releasably secure the tool for rotation about said second axis; and a coupling operatively attached to said rotary instrument and configured to releasably secure said drive assembly to said rotary instrument in a plurality of orientations to selectively position said second axis relative to said rotary instrument along different trajectories selectively maintained by the surgical robot.
 31. The end effector as set forth in claim 30, wherein said geartrain of said drive assembly comprises at least one reduction gearset interposed in rotational communication between said rotary instrument and said connector such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 32. The end effector as set forth in claim 31, wherein said at least one reduction gearset comprises a planetary gearset.
 33. The end effector as set forth in claim 30, wherein said geartrain of said drive assembly comprises at least one bevel gearset interposed in rotational communication between said rotary instrument and said connector to translate rotation about said first axis into rotation about said second axis.
 34. The end effector as set forth in claim 33, wherein said bevel gearset comprises a reduction gearset configured such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 35. The end effector as set forth in claim 33, wherein said geartrain of said drive assembly further comprises at least one reduction gearset interposed in rotational communication between said rotary instrument and said bevel gearset such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 36. The end effector as set forth in claim 33, wherein said geartrain of said drive assembly further comprises at least one reduction gearset interposed in rotational communication between said bevel gearset and said connector such that rotation of said rotary instrument occurs at a different speed than rotation of the tool.
 37. The end effector as set forth in claim 36, wherein said geartrain of said drive assembly further comprises at least one auxiliary gearset interposed in rotational communication between said rotary instrument and said bevel gearset.
 38. An end effector for guiding tools relative to a surgical site along a trajectory maintained by a surgical robot, the tools including a first tool and a second tool different from the first tool, said end effector comprising: a mount adapted to attach to the surgical robot; an actuator coupled to said mount and configured to generate rotational torque about a first axis; and a drive assembly comprising: a geartrain to translate rotation from said actuator about said first axis into rotation about a second axis, a drive conduit supported for rotation about said second axis, a first rotational lock operatively attached to said drive conduit to releasably secure the first tool for concurrent rotation about said second axis, said geartrain of said drive assembly comprises at least one reduction gearset interposed in rotational communication between said actuator and said drive conduit such that rotation of said actuator about said first axis occurs at a different speed than rotation of said first rotational lock about said second axis, a second rotational lock, different from said first rotational lock, operatively attached to said drive conduit to releasably secure the second tool for concurrent rotation about said second axis, with said second rotational lock disposed in rotational communication with said geartrain such that rotation of said second rotational lock about said second axis occurs at a different speed than rotation of said first rotational lock about said second axis, and an axial lock to releasably secure one of the first tool and the second tool for concurrent translation with said drive conduit along the trajectory maintained by the surgical robot, said axial lock being operable between: a release configuration wherein relative movement between said drive assembly and the secured tool is permitted along said second axis, and a lock configuration wherein relative movement between said drive assembly and the secured tool is restricted along said second axis.
 39. The end effector as set forth in claim 38, wherein rotation of said second rotational lock about said second axis occurs at a ratio of 1:1 with respect to rotation of said actuator about said first axis.
 40. An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having an interface end and a working end, said end effector comprising: a mount adapted to attach to the surgical robot; an actuator coupled to said mount and configured to generate rotational torque about a first axis; and a drive assembly comprising: a geartrain to translate rotation from said actuator about said first axis into rotation about a second axis, a drive conduit supported for rotation about said second axis, said geartrain of said drive assembly comprises a transmission interposed in rotational communication between said actuator and said drive conduit, said transmission comprising a first gearset, a second gearset, and a shift collar arranged for movement between: a first collar position where said shift collar engages said first gearset to translate rotation between said actuator and said drive conduit at a first drive ratio; and a second collar position where said shift collar engages said second gearset to translate rotation between said actuator and said drive conduit at a second drive ratio different from said first drive ratio, a first rotational lock operatively attached to said drive conduit to releasably secure the tool for concurrent rotation about said second axis, and an axial lock to releasably secure the tool for concurrent translation with said drive conduit along the trajectory maintained by the surgical robot, said axial lock being operable between: a release configuration wherein relative movement between said drive assembly and the tool is permitted along said second axis, and a lock configuration wherein relative movement between said drive assembly and the tool is restricted along said second axis.
 41. The end effector as set forth in claim 40, wherein said transmission further comprises a transmission linkage operatively attached to said shift collar for concurrent movement between said first collar position and said second collar position, said transmission linkage defining a selector arranged to engage at least a portion of the tool to move said shift collar to said second collar position when said axial lock is in said lock configuration. 